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Return Patient Update Form

Return Patient Update Form

    ***if yes, please bring insurance card to appointment and verify eligibilty dates before coming for exam***
  • If you wish to process your exam or eyewear fees through private health care insurance, please ensure all this information is accurate (names are written as on card) and up to date.
  • This field is for validation purposes and should be left unchanged.
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January 4, 2020: WE ARE OPEN! As health care providers, we are open during this most recent lockdown by the Province. Acton Eyecare takes the well-being of our patients and staff very seriously and we are doing everything we can to minimize risk to all. If you are planning on visiting our office, please call to book an appointment for eye exams, purchasing glasses, drops, adjustments and repairs. We appreciate your ongoing support and patience during this time.