Founders Parkway Vision Center

Please fill this out and bring it with you to your exam. If you wear contacts, please bring any information about your current contacts or your old boxes with you. Thank you!
Please note, we require 48 hours notice for appointment cancellations, a $25.00 fee may be assessed.

If you or child are struggling in school or at work, please fill out the Child / Student History form and bring it with you to your exam. Thank you!

If your teacher has referred you to our office, please have them fill out the Teachers Observation check list for you and bring it with you to your exam.
Thank you!

  This PDF requires a free plugin that may have come included with your browser. If you are having difficulties opening this file Click Here to go to Adobe's web site for Acrobat Reader.