My Eye prescription

You can pick up your medical records (Eyeglasses Rx or Contact Lenses Rx) in person from the office for free ($0)       Monday - Friday  9 am - 4:30 pm

Authorization to Release My Medical Records.
​I hereby authorize the following healthcare Greater Valley Optometry to release my prescription Copy by Email to me.
By submitting this form you are agreeing ​to receive by email your prescription ​copies for eyeglasses.

​Authorization to Release My Medical Records.
​I hereby authorize the following healthcare Greater Valley Optometry to release my prescription Copy by Email to me.
By submitting this form you are agreeing ​to receive by email your prescription ​copies for eyeglasses.

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Authorization to Release My Medical Records.
​I hereby authorize the following healthcare Greater Valley Optometry to release my prescription Copy by Email to me.
By submitting this form you are agreeing ​to receive by email your ​contact lenses prescription copy.

Authorization to Release My Medical Records.
​I hereby authorize the following healthcare Greater Valley Optometry to release my prescription Copy by Email to me.
By submitting this form you are agreeing ​to receive by email your ​contact lenses and Eyeglasses prescription copy.

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Authorization to Release My Medical Records.
​I hereby authorize the following healthcare Greater Valley Optometry to release my Retinal imaging Copy by Email to me.
By submitting this form you are agreeing ​to receive by email your Retinal imaging copies for your eyes. 

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You can pick up your medical records (Eyeglasses Rx or Contact Lenses Rx) in person from the office for free ($0) M - F 9 am - 4:30 pm

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