Mt Bethel Eye Care
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Patient Forms.

Please fill out the following patient information forms and bring them 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.

  • Patient Information Form
  • Privacy Policy

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Location.
​9 Mt Bethel Plaza
Rt. 512 (near Rt. 611)
​Suite 65
Mount Bethel, PA  18343

Phone: 570-897-5911


Office Hours
Mon:  9:00 a.m. - 5:00 p.m.
Tue:  9:00 a.m. - 5:00 p.m.
Wed:  9:00 a.m. - 5:00 p.m. 
Thu:  9:00 a.m. - 5:00 p.m.
Fri:   9:00 a.m. - 2:00 p.m.
(closed one Friday a month)

​Sat:  CLOSED 
Sun: CLOSED


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Notice_of_privacy_practices.pdf
File Size: 118 kb
File Type: pdf
Download File

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