Visit us on Facebook today Twitter coming soon
Molalla and Milwaukie Family Eye Care  

Welcome,

New Patients!

Welcome Back,

Existing

Patients!

We're pleased to offer you the convenience of filling out your appointment paperwork before your exam.  
Please complete the printable form and bring it with you to your appointment.             

You'll also need to bring the following items:
Current insurance card
Current and/or old glasses
Current sunglasses
If you wear contact lenses, bring in your contact lens box that has contact lens information for each eye
  And please remember to bring your backup glasses

Molalla Family Eye Care
Patient Form
Click to print
Milwaukie Family Eye Care
Patient Form
Click to print

Printable forms are available in Adobe PDF format.
If you don't already have Adobe Acrobat installed, click on the link below to get the free Reader.

Copyright Molalla - Milwaukie Family Eye Care Inc. All rights reserved.