Palozej Eyecare
  • Home
  • Doctors
  • Services
  • Products
  • Eye Health
    • Eye Conditions
    • Vision Conditions
    • American Optometric Association
    • Connecticut Association of Optometrists
  • Patient Forms
  • Contact Us
  • COVID-19 Information
Select Page

Patient Forms

There areĀ several patient forms each individual needs to fill in. Completing these prior to office visits helpsĀ ensure timely service.

"

Hippa Privacy Practices

"

Insurance Form

"

Medical History Questionnaire

"

Medical vs. Routine Exams

"

Contact Lenses Fitting Policy

"

Contact Lens Instructions

"

Dry Eye Questionnaire

Tolland Office

384A Merrow Road
P.O. Box 70
Tolland, CT 06084

Phone: 860.870.4632
Fax: 860.870.4634

Tolland@palozejeyecare.com

Stafford Office

72-II West Stafford Road
P.O. Box 24
Stafford Springs, CT 06076

Phone: 860.684.2191
Fax: 860.684.5346

Stafford@palozejeyecare.com

  • Facebook
Copyright 2022 Palozej Eyecare | Designed by Waypoint Innovations