BUENA VISTA EYELAND INC
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📄 Forms Available for Download
Please print and complete the following forms prior to your appointment. Bring them with you and present them at check-in.
  • ✅ One (1) Patient Intake Form – required per patient
  • 🔐 One (1) HIPAA Acknowledgment Form – required per patient
  • 👁️ Contact Lens Disclosure Form – only required if you are receiving a contact lens exam
These forms help us streamline your visit and minimize wait times. Thank you! 
Intake Form
File Size: 309 kb
File Type: doc
Download File

Intake Form Spanish
File Size: 57 kb
File Type: docx
Download File

HIPPA Form
File Size: 73 kb
File Type: docx
Download File

Contact Lens Disclosure
File Size: 18 kb
File Type: docx
Download File


𝐁𝐮𝐞𝐧𝐚 𝐕𝐢𝐬𝐭𝐚 𝐄𝐲𝐞𝐥𝐚𝐧𝐝
​

○ Pediatric eye care  ○ Contact Lens  ○ Sports Vision  ○ Surgical Co-Management  ○ Full Service Optical  ○ Family eye care
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''We focus on your quality of life''
​

📞 Phone: 772-388-9330
📠 Fax: 772-388-3036
📍 Address:
1619 US HIGHWAY 1
Sebastian, FL 32958
🕒 Hours of Operation 
​Monday – Thursday: 8:00 AM – 5:30PM
Friday : 8:00 AM – 2:00PM
August through May:
  📅 First Saturday of Each Month: 8:00 AM – 2:00 PM

Copyright © 2021  Website by Eyefinity
  • Home
  • About Us
  • Services
  • Eyewear
  • Patient Forms
  • Contact Us