DUBIN OPTOMETRIC CLINIC
  • Home
  • Our Practice
  • Our Services
    • Eye Care for Children
    • Dry Eye
  • Patient Forms
  • Location
  • Request an Appointment
Medical History Questionnaire
Medical History Questionnaire:  
Please fill out and bring along any medical and vision insurance cards to your appointment.


The eyes are a "window to the body" and understanding your Medical History can help our doctors provide the best possible eye care. 
Picture
Contact Us:
Dubin Optometric Clinic 
37085 Grand River, Suite D
Farmington, MI 48335
248-477-1616
[email protected]
Office Hours:     
Monday 9:00-5:00
Tuesday 9:00-6:00
Wednesday 9:00-5:00
Thursday 9:00-7:00
Friday 9:00-3:00
Saturday 8:00-1:00

Notice of Privacy Practices
Website by Eyefinity
  • Home
  • Our Practice
  • Our Services
    • Eye Care for Children
    • Dry Eye
  • Patient Forms
  • Location
  • Request an Appointment