Welcome to online registration for Optical Eyeworks. Please take a moment to fill out this information. It will help us better assist you on the day of your appointment. If you need assistance with this, please call us at (954)757-2468. Completing this information will assist us in providing eye care custom designed for your particular needs.
Vision Insurance Information
Please complete this so we may verify your benefits before your visit. Enter the insured person first name (primary member covered), date of birth and place of employment. You will need to look at your insurance card to complete this.
Referral Information
Whom may we thank for referring you? Our "Share the Care" program offers substantial savings for referring friends and family.
MEDICAL RECORDS
Medications
Allergies
If Diabetic
Ocular History
Family History