BUTLER EYECARE
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patient  forms

Patient Forms


registration_form.pdf
File Size: 767 kb
File Type: pdf
Download File

hippaa_form.pdf
File Size: 700 kb
File Type: pdf
Download File

NEW TO OUR OFFICE? 

SAVE TIME AND FILL OUT YOUR "PAPER WORK" BEFORE YOU COME FOR YOUR APPOINTMENT.
Contact Us
34 South Main Street Suite 5
Wilkes-Barre, PA 18701
Phone: 570-822-8727
 Office Hours Are Now By Appointment Only Due To Covid-19.
Please Call Ahead.


 

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Website by Eyefinity

  • Home
  • Our Practice
    • Changes in Hours
    • In the News
    • Ribbon Cutting
  • Our Services
    • Eyewear Gallery
    • Promotions
    • Special Events
  • Patient Forms
  • Eye Care Articles
  • Order Contacts
  • Location
  • In the News
  • In the News