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Our practice is here to offer you the best in eye care

Patient Forms


Please fill out the following patient information form and bring it  with you to your first visit. Signing "Acknowledgment of Receipt of Privacy Practices" on the form signifies that you have read the Privacy Policy, listed below.
 
  • New Patient Info/Medical History
  • Privacy Policy

[NOTE: This PDF requires a free plugin that may have come included with your browser. If you are having difficulties opening this file Click Here to go to Adobe's web site for Acrobat Reader.]
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Location info...
Shades Of Brooklyn
1619 Pitkin Avenue
Brooklyn, New York 11212

Phone: 718-342-4300
Fax: 347-350-6601


Office Hours
Mon, Tue, Wed, Thu, Fri: 9:00 am - 5:30 pm
Sat: 9:00 am - 4:30 pm

Email: shadesofbrooklyn@yahoo.com

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Notice of Privacy Practices.
  • Home
  • Location
  • Services
  • Patient Forms
  • Contact Lenses/Reorder
  • Contact Us
  • Our Team