Family Optometry Center - Patient Forms
Family Optometry Center

We need this form completed for each patient, including children and it needs to be updated as changes occur.

If you are coming to our office for the first time please complete this form and bring it to your eye exam.

For those patients who are returning to our office please make any updates to this form and bring in at the time of your exam.


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Contact Us
1559 Farmers Lane
Santa Rosa, CA 95405
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Located in Farmers Lane Plaza to the left of Rite Aid. If you want to set up an appointment, you may call us or click on "Contact Us" on this page and email us.



Phone: 707-571-2020
Fax: 707-577-7351
e-mail us

Mon-Tue, Thu-Fri 8:30am - 5:30pm
Wed Noon - 6:00pm

Closed for lunch 12:30 to 1:30 Mon,Tue,Thu,Fri




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