Online Forms
At Holicki Eye Centers and Optical, we offer patient forms online so you can complete them in the convenience of your own home or office. Fax or email us your completed forms or bring them with you to your visit.
If you do not already have AdobeReader® installed on your computer, Click Here to download it now.
Download the necessary form(s) and fill in the required information.
Fax or email us your completed form(s) or bring them with you to your appointment.
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Demographic and Medical History Form
- DOWNLOAD
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Notice of Privacy Practice
- DOWNLOAD
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Amsler Grid
Commonly used for Age-Related Macular Degeneration patients - Print Our Free Amsler Grid
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Have Dry Eyes
About dry eyes and what you can do to help! - Print Out Our Dry Eye Disease Information
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Having Cataract Surgery with Us?
For those of you that had cataract surgery with our clinic. - Patients Having Surgery On A Monday Patients Having Surgery On A Wednesday
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Want to share your experience? Patient Testimonials
- Download and Print
Contact Info
(517) 278-3393
- Monday: 8:00am - 5:00pm
- Tuesday: 8:00am - 5:00pm
- Wednesday: 8:00am - 5:00pm
- Thursday: 8:00am - 5:00pm
- Friday: 8:00am - 5:00pm
- Saturday: Closed
- Sunday: Closed
Follow Us
Contact Info
(517) 278-3393
- Monday: 8:00am - 5:00pm
- Tuesday: 8:00am - 5:00pm
- Wednesday: 8:00am - 5:00pm
- Thursday: 8:00am - 5:00pm
- Friday: 8:00am - 5:00pm
- Saturday: Closed
- Sunday: Closed
Follow Us
Contact Info
(517) 278-3393
- Monday: 8:00am - 5:00pm
- Tuesday: 8:00am - 5:00pm
- Wednesday: 8:00am - 5:00pm
- Thursday: 8:00am - 5:00pm
- Friday: 8:00am - 5:00pm
- Saturday: Closed
- Sunday: Closed
Follow Us
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