Boulder County Eye Care - Patient Referral Form Confirmation

Are you experiencing?

Has your prescription for eyeglasses changed more often than usual?

Do you need brighter light for reading?

Does your vision sometimes seem distorted?

Have you experienced double vision in one eye only?

Do you see “ghost” images?

How do you prefer to have a member of our clinic’s staff follow up and contact you?

We will follow up with you soon.