Kelowna Optometry Clinic | NuVue Optometry | Call 778-484-1650

Patient Form

New Patient Form

Welcome to our office! Please take a few moments to complete this form so we can care for your eye health and vision needs.


    Medical History

    Allergies/Hay FeverDiabetesHypertensionThyroid DiseaseStrokeAutoimmuneCancerOther

    Allergies

    AntibioticsAnti-inflammatoryAnestheticMore Info

    Current Medications








    How did you hear about us?

    MagazineYouTubeWord of mouthWebsiteGoogleTVRadioFriend/FamilySocial MediaStreet Sign

    Ocular History

    Retinal DetachmentLazy Eye/AmblyopiaGlaucomaCataractMacular DegenerationOther

    Retinal DetachmentLazy Eye/AmblyopiaGlaucomaCataractMacular DegenerationOther

    Eye Surgery (If Applicable)

    LasikPRKCataractRetinaOther

    Contact Lenses

    InterestedCurrent Wearer

    Dry Eye

    Controlled with artificial tearsNeed a better treatment





    I have read and agree to the eplained fees and understand the doctor has opted out of the medical services plan of British Columbia, and may bill a portion of my exam to MSP where applicable on my behalf. If MSP does not cover the cost of any of the examination, I am fully responsible for the costs, as a patient or guardian.

    EmailTextPhone
    Sunglass Sale
    $300 OFF
    Progressive sunglasses when you purchase a set of Personal Fit progressives with frames
    Progressive sunglasses when you purchase an office lens or Digitial Fx progressives with frames
    $200 OFF
    Plano Sunglasses $50 off.
    $125 OFF
    Prescription sunglasses when you purchase a complete set of single vision glasses
    Not to be combined with other office special
    Calvin Klein, Ray Ban, Tiffany & Co, Vinyl Factory, Chloe & Jimmy Choo
    Up to $100 in Savings!
    $50, $75 & $100 off select styles.
    Designer Frame Blowout!
    Sale ends on October 31st, so come visit NuVue Optometry while supplies last!
    ONE DAY ONLY MAY 11th
    9am
    to
    4pm









    The most recent BC government update requires facial coverings in public indoor spaces.
    Equipment and chairs will be sanitized between each patient
    Masks and hand sanitizer will be provided if needed
    Frames will be sanitized after being tried on. Optical appointments are available for booking.
    We recommend booking a private optical appointment if you would like to shop for frames. This allows for us to maintain social distancing in the office.
    We are currently open regular office hours. The health and safety of our patients is our top priority during the COVID-19 pandemic. These are some of our office protocols to keep you safe: