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Online Forms
Home   Online Forms
At Valley Vision Clinic & Optical, we value your time. In an effort to save you time in our office, you can download and complete our patient form(s) prior to your appointment.
  • Fax your printed and completed form(s) to our office or bring them with you to your appointment.

New Patient Health History Form – Required

Please complete this form as it lets us know the history and current state of your health. Let us know what questions, concerns, and goals your have regarding your eye health or vision on the form.
Contact
us
Office hours 
& location
Monday
8:00 am - 12:00 pm
Tuesday
8:00 am - 12:00 pm
Wednesday
8:00 am - 12:00 pm
Thursday
8:00 am - 12:00 pm
Friday
8:00 am - 12:00 pm
Saturday & Sunday
Closed
Valley Vision Clinic & Optical
145 N 100 E
Richfield, UT 84701
Valley Vision Clinic & Optical is dedicated to serving each patient with the best vision care in the world. To better serve our patient's healthcare needs, we provide the latest in vision technology, the newest diagnostic procedures, and state of the art eyewear and lenses. Our goal is for each patient to feel our love through all we do.
EXPLORE
OUR LOCATION
145 N 100 E
Richfield, UT 84701