Book an Eye Exam with one of our friendly optometrists

Hey, Bright eyes ;) Fill out some info and we will be in touch shortly. We can't wait to hear from you!

Name

First Name

Last Name

Phone

(###)

###

####

Is this a home or cellphone number?

Cell phone

Home phone

What is your date of birth?

MM

DD

YYYY

Are you under any insurance company?

If other, which company?

Does the person you are booking for fall into any of the following categories?

Please check all that apply. This is necessary and has to do with health card billing for the eye exam.

Ontario works

ODSP

65 years or older

19 years or younger

Diabetic (taking medication for diabetes)

Diabetic (not taking medication for diabetes)

None of these apply

Health Card Number

Necessary if you are diabetic, on ODSP/OW, 19 or under, 65 or over.

This is a place to add additional information i.e. if you are booking for multiple people

Book your Eye Exam Today

Our Services

glasses • contact lenses • repairs • prescription lenses only • frames only • glasses adjustments • trained staff to assist

SUBSCRIBE TO OUR