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Patient Registration Form

/Patient Registration Form
Patient Registration Form2017-03-05T16:53:57+00:00

Patient Registration Form

Prior to your office visit, please follow the instructions below to complete the Patient Registration Form.

INSTRUCTIONS:

  1. Download and save the Patient Registration Form PDF file.
  2. Open the Patient Registration Form PDF file.
  3. Print the Form.
  4. Fill out the Patient Form completely.
  5. Please sign the Form and bring it with you to your office visit. Thank you.

* The Patient Registration Form is Adobe Acrobat PDF format. Adobe Acrobat Reader. Adobe PDF Reader

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21475 Ridgetop Circle Suite 300
Sterling, VA 20166

1.888.844.2020

BETTER VISION THROUGH BETTER CARE

Since 1989 The Eye Center has been on the forefront of vision correction procedures. Dr. Boutros and The Eye Center are two names that have come to define a standard of excellence in vision correction.

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Christmas in July LASIK Event! (Extended Through August)

If you’ve had it with glasses and contacts, and are ready to improve your life, then listen up, because the Eye Center has extended Christmas in July for one more month!We’re celebrating the holidays early this year by offering you our best savings of the year of $2,500 off LASIK! That’s right, now through August, it’s Christmas in July on LASIK with Dr. Boutros – with over 25 years of experience.Shop early this year and receive our biggest savings of the year on some of the most advanced LASIK technology in the country, iLASIK with iFlap. It’s everything you deserve – the right technology in the right hands all at the best price.Show your eyes some holiday cheer this summer and don’t miss The Eye Center’s Christmas in July LASIK Event! Now through August!Schedule Your Free Consultation!