New Patient Information

Want to save time during your first visit with us?


Please print and fill out the following NEW PATIENT FORMS and bring them with you to your first appointment:


1. Directions for filling out New Patient Forms

2. Patient Information Form

3. Financial Responsibility Form

4. Privacy Information Form

5. Cancellation Fee Notice


These forms are available for printing under the "New Patient Forms" tab.

Don't forget to bring your insurance information with you


To register and treat you promptly, we request that our patients bring their current insurance information with them for each visit.

Don't forget to bring your current glasses and contact lenses with you


To give you the best care possible, we recommend you bring your current glasses and contact lenses with you. If you do not have any contacts left, please bring your boxes and/or a copy of your prescription.

Contact us

Phone: 215 536-5583

Fax: 215 536-8640

Office & Optical Hours





9:00am to 2:00pm and

3:00pm to 8:00pm



9:00am to 3:00pm



9:00am to 2:00pm and

3:00pm to 8:00pm



9:00am to 3:00pm


Saturdays & Sundays


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© Quakertown Eye Associates, P.C.