Patient Information

Download Patient Forms

Patient Information 1
Vision Care & Therapy Center

Patient Forms

Our Patient Forms are listed below. Simple Click on the Form required for your appointment ~ you will be directed to a PDF file of the form which you can download from your browser.

Once you’ve completed your form(s) please fax to 678-256-3995, prior to your appointment or bring it with you.

(If you don’t have the Adobe Reader App installed on your computer; please click here.)

Patient Form

Patient Form

Adult Eye Exam Form

Patient Form

Patient Form

Adult Questionnaire

Patient Form

Patient Form

Child Questionnaire

Patient Form

Patient Form

Child (Extended) Questionnaire

Patient Form

Patient Form

Rehab Questionnaire

Success Stories

What Our Patients Say

Patient Information 2

Before eye therapy, I was not comfortably reading out loud in the classroom. I was late with my assignments and was pulled out of my language arts. I was also three grade levels behind my class in reading. Reading was a chore for me. Now my grades have improved and I will raise my hand to read out loud in class. I have improved two levels in reading and I am beginning to enjoy reading. Soon I expect to be above grade level. Assignments are completed on time and I am working more independently with my homework. Look at my handwriting it’s the best now.

Gwynn | Patient

Patient Information 3

CONTACT US

Vision Care & Therapy Center

Patient Information 4

Dr. Janna Iyer, FCOVD

Dr. Alayna Larsen

 

12020 Etris Road, Ste B-100

Roswell, Ga 30075

678-256-3990

Office Hours

Mon-Thu 9:00am-6:00pm

Fri  9:00am-1:00pm

Appointments

678-256-3990

 

APPOINTMENTS

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Please note this is only a request. We will call you to confirm an appointment. Thank you.