MAKE AN APPOINTMENT

Please fill out the form below to make an appointment.  A representative will contact you shortly to let you know if the day and time you request is available.

Name:   
Telephone:   
Fax:   
E-Mail:   
Appointment Date Requested:    Month: Day: Year:
Appointment Time Requested:    Office Hours: Monday to Friday 8:30 am to 5:00 pm  
   
Appointment with: Dr. Komarnicky       Dr. Gafur        Dr. Carpenter

Please schedule me for a:

General Eye Examination
     
Please be advised that as of  November 19, 2001 the Medical Services Plan of   
     B.C.  no longer pays for general eye examinations for persons age 19 to 64        inclusive.   Persons with diabetes, AIDS or other diseases with ocular        manifestations may be covered.  

Contact Lens Fitting or Follow-up
     
Please be advised that
contact lens services are not covered by the Medical 
      Services Plan of B.C.

Laser Refractive Surgery Pre-Operative Assessment
     
Please be advised that the Medical Services Plan of BC does not cover elective
      refractive surgery pre-operative care.

Laser Refractive Surgery Post-Operative Assessment
     
Please be advised that
the Medical Services Plan of BC does not cover elective
      refractive surgery post-operative care.

Orthokeratology Consultation...a non surgical alternative to laser surgery 
      Please be advised that this service is not covered by the Medical  Services
    
 Plan of  B.C.
   


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Downtown Vancouver Optometry Clinic
Toronto Dominion Bank Tower
1440-700 West Georgia Street
Vancouver, B.C. Canada  V7Y 1C6
Ph. 604-681-5351  Fax: 604-682-3314  email: info@myeyesonline.com

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