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Patient Forms

To make your visit go smoothly with effective use of your time we ask that you be prepared for your visit.

When you schedule your appointment, either online or by phone, you will have the opportunity to save time at your next office visit. When you provide your email address you will receive the initial patient paperwork to complete prior to your arrival. See the additional forms below to complete prior to your visit to save even more time.

New Patient Information (PDF)

Patient Medical History (PDF)

Retinal Photography Consent (PDF)

Notice of Privacy Practices (review online prior to visit)

 

Please bring your insurance card and a photo ID, such as a license, for each office visit.

Please note our policy regarding payments due at the time of the visit prior to your visit.


Contact us
with any questions you may have or to schedule an appointment.

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Designer Gallery

 
 

Dr. Leitzel
Introducing Dr. Leiitzel

We are pleased to announce the addition of Dr. Andrew Leitzel to our team of doctors. Dr. Letizel was born and raised in central Pennsylvania. He graduated with clinical honors from Pennsylvania College of Optometry.  In 2009 he was awarded the Young Optometrist Of The Year by the Central PA Optometric Society. For the past 8 years he has practiced in a large ophthalmology practice providing primary optometry services including comprehensive eye health exams, diabetic eye exams, glaucoma disease management, dry eye management, medical treatment of eye infections and contact lens fittings. Schedule an appointment today with Dr. Leitzel.

Get in touch

Manchester/North York

Schedule an Appointment

717.266.5661 :: Get Directions • Contact UsLearn More

East York

Schedule an Appointment

717.755.6906 :: Contact Us Get DirectionsLearn More

For both offices please call 717.495.3097 for emergencies or after hours.

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We Now Have Ray Ban Sunglasses!

We Now Have Ray Ban Sunglasses!

Come in today and check out our Ray Ban Sunglasses and the rest of our designer frames and sunglasses at either of our offices.

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