Online Patient Registration Form

Online patient registration helps us to prepare your file in prior to the start of your appointment. Please complete the information below and submit the secure form online.
 This form contains confidential information and is delivered to our clinic through a secure internet connection.

Personal Information


Glasses History

Please bring all glasses to your appointment.


Contact Lens History

Please bring all contact lenses (including contact lens boxes) to your appointment.


Comments


Contact Us

#12, 80 Bow Street, Cochrane, Alberta

Located across from Save-On-Foods

Phone: (403) 932-0918
Fax: (403) 932-0899

Hours of Operation

  • Monday9:00 AM - 5:30 PM
  • Tuesday9:00 AM - 5:30 PM
  • Wednesday8:00 AM - 8:00 PM
  • Thursday8:00 AM - 8:00 PM
  • Friday9:00 AM - 5:30 PM
  • Saturday9:00 AM - 3:00 PM
  • SundayClosed

We Are Proud Members Of The Eye Recommend Network Of Optometrists.