CONTACTS & GLASSES - RONDA MORREALE OD
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patient  forms

Patient Forms


Please print these forms out, fill them out and bring them into the office with you on your day of your appointment.
​
Thank you!
Page 1 - Medical History Form
​Page 2 - Medical History Form
​Page 3 - Medical History Form
Page 4 - HIPPA Form
Contact Us
1124 S. Wickham Road
West Melbourne, FL 32904
Phone: 321-914-0317
Fax:​ 321-914-0142
Email:  contactsandglassesinc@cfl.rr.com
​Office Hours
Our lunch is from
12noon to 1:15pm daily
Mon    9:00 am - 4:45 pm
Tue     9:00 am - 4:45 pm
Wed    9:00 am - 4:45 pm
Thu     9:00 am - 4:45 pm
Fri       9:00 am - 3:45 pm
Sat     Closed
Sun    Closed
We will be closed November 24 and 25 for the Thanksgiving Holiday.


Notice of Privacy Practices
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