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Dear Valued Patient, our office is OPEN and We’re Here for YOU! We never closed during the COVID-19 shutdown, we just practiced safety protocols.
You can view our safety protocols here.

Distinction in Eyewear and Eyecare

Home » Contact Us » New Patient Forms

New Patient Forms

If you want a printable version, click here.

New Patient Intake Form

New Patient Registration Form

HIPAA Information and Consent


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Optometric Associates, New Holland, Pa. from David D. Speace on Vimeo.