Fayette EyeCare
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Patient Forms

Patient Forms

Welcome Form
File Size: 35 kb
File Type: pdf
Download File

Health History
File Size: 34 kb
File Type: pdf
Download File

HIPAA Notice
File Size: 115 kb
File Type: pdf
Download File

HIPAA Patient Receipt
File Size: 117 kb
File Type: pdf
Download File

Contact Us:
7 Commercial Avenue
Washington C. H., OH 43160
740-335-1181
​740-335-1182 (fax)

info@fayetteeyecare.net
Hours:
Monday:           9:00 am - 5:00 pm
Tuesday:           9:00 am - 5:30 pm
Wednesday:    9:00 am - 5:00 pm
Thursday:         9:00 am - 5:00 pm
Friday:               9:00 am - 4:00 pm
Notice of Privacy Practices
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  • Home
  • Our Practice
  • Our Services
  • Patient Forms
  • Promotions
  • Eye Care Articles
  • Our Eyewear
  • Insurance
  • Location