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COVID-19 Policy
About Us
Doug and Randy
Dr. Amanda Klassen
Eye Exams
Eyewear
Lenses
Frames
Sunglasses
Children's Eye Care
Contact Lenses
Teleoptometry
Contact Us
Home
COVID-19 Policy
About Us
Doug and Randy
Dr. Amanda Klassen
Eye Exams
Eyewear
Lenses
Frames
Sunglasses
Children's Eye Care
Contact Lenses
Teleoptometry
Contact Us
Please complete the this Intake Questionnaire carefully. If you have a
question
, please email us and we will respond within one working day.
Question
Intake Questionnaire
*
Indicates required field
Name
*
First
Last
Date
*
OHIP Number
*
Email
*
Phone Number
*
Street Address
*
Apt.
*
City
*
Postal Code
*
Submit
Contact Us
