Clompus Reto & Halscheid Vision Associates
wedge shape graphic
About Clompus Reto & Halscheid
Visit Our Offices
Meet Our Doctors
Eyecare Resources
Request An Appointment
  button West Chester Office
  button Exton Office
  button New Patient Forms
end side navigation
 
Request An Appointment at our Chester Springs Office
   
 

New Patient Forms

New patients: Please print out the appropriate form from the list below and bring the completed form with you to your first appointment.

If you have any questions about these forms, please call either our West Chester (610-696-1368) or Exton (610-363-8960) office and we will be happy to assist you.
 
spacer
bulletNew Patient Questionnaire for Comprehensive Eye Examinations with
Drs. Reto, Halscheid & Bakker
bulletParent's Questionnaire for Services with Dr. Scheiman

bulletPatient Symptom Questionnaire for Services with Dr. Scheiman
bulletPatient Satisfaction Survey

bulletSchool Vision Questionnaire

bulletDry Eye Questionnaire

Clompus, Reto & Halscheid Vision Associates, P.C.•Eye Care Center Locations

1450 E. Boot Road, Bldg. 700B, Goshen Executive Center, West Chester, PA 19380 | Phone: 610-696-1368 | Directions

93 West Devon Drive, Exton, PA 19341 | Phone: 610-363-8960 | Directions

Clompus, Reto & Halscheid. All rights reserved.