PALMER EYECARE CENTER
860-346-2020
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Patient Forms

Patient Registration and History
File Size: 169 kb
File Type: pdf
Download File

Please click on the "Patient Registration and History" link above to access the form and print it out. It consists of 2 pages.
 
Please fill out the form as completely as possible so that we may better be able to care for you. Bring both pages with you to your appointment.
 
If you have any questions, you may always call the office at 860-346-2020.
 
Thank you. 
  
Contact Us
Palmer Eyecare Center
282 Main Street Extension
Sanseer Mill Office Park
Middletown, CT 06457
Phone: 860-346-2020
Office Hours
Mon    8:30 am - 5:00 pm
Tue     8:30 am - 5:00 pm
Wed    8:30 am - 6:00 pm
Fri       8:30 am - 4:00 pm
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