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Myopia Control Consultation Request

** Please Note:  This request form is for children that have been diagnosed with myopia and would like to have myopia management done.  It is not an eye exam request.  If your child has not had an eye exam done within the last year, please book your child an eye exam first by clicking here.
Are you a new patient to the clinic?
Has your child had an eye exam within the last year?

(if your child has not had an eye exam in over a year, please book one by clicking here).

Thanks for submitting! Our office will contact you via email shortly!

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