EYE PLACE OPTOMETRY
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FOR PATIENTS

Contact Lens Rule Update
Under new Federal Trade Commission (FTC) rule, patients must give written consent/authorization, allowing the eye doctor to provide a digital copy of their contact lens prescription.
If patient would like a copy of their contact lens prescription emailed to them, patient must first email the office their digital consent with an e-signature. Our email is eyeplace2020@yahoo.com.
"I authorize my eye doctor to provide me with a digital copy of my contact lens prescription by email. [insert e-signature]"

Ordering Contacts? Website here.

*NEW PATIENTS*
Please fill out our patient information form prior to your upcoming appointment. You may either:
  • print out the completed form and bring it to your appointment
  • take a photo or scan the completed form and email us at eyeplace2020@yahoo.com
PATIENT INFO FORM
NOTICE OF PRIVACY PRACTICES

Eye Place Optometry


1136 E Green St
Pasadena, CA 91106

626-792-9979

Sun: CLOSED
Mon: CLOSED
Tues: 10:00a - 6:00p
Wed: 10:00a - 6:00p
Thurs: 10:00a - 6:00p
Fri: 10:00a - 6:00p
Sat: 9:00a - 4:00p

Picture
Copyright © 2020  Website by Eyefinity
  • Home
  • About Us
  • Services
    • Exam
    • Glasses
    • Contact Lens
  • For Patients
  • Contact Us