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Located 2 doors down from Dunkin Donuts on Union Valley Rd

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Home » Welcome Form

Welcome Form

We are pleased to welcome you to our practice. Please take a few minutes to fill out this form as completely as you can. If you have any questions, we will be glad to help you. We look forward to working with you in maintaining your health.

  • Patient Information

  • Date Format: MM slash DD slash YYYY

  • I agree to allow SolutionReach (our online system) to use this information in providing my services. We do not share information.

  • Account Responsibility

    (If different from above)
  • Date Format: MM slash DD slash YYYY

  • Medical Insurance Information

    (If different from above)
  • Date Format: MM slash DD slash YYYY

  • Vision Plan Information/Secondary

    (If different from above)
  • Date Format: MM slash DD slash YYYY

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As our community copes with the fast-moving spread of the COVID-19 coronavirus we hope you and yours are in good health during these stressful times.

Public officials have asked businesses to close down for a limited time while a local quarantine begins. 

We will be available for eyecare emergencies by appointment. Please contact us at 973-728-1101 if you have any questions and we will respond back as quickly as we can. All other emergencies please call 911.

If you need to order contact lenses you can do so by going to our website www.westmilfordvisioncenter.com and click on the contact lens order link on the left hand side of the screen.

When we are given the green-light to renew normal business operations we will update you. We thank you for your patience during this interruption and hope to see you when we re-open, happy and healthy.

West Milford Vision Center

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Even though we are closed we are still available to serve our patients. We are just a phone call away!

If you have an eye emergency, please contact us- we’re here for you.

If you need to order contacts, please visit our website and do it online.

Finally, we can also help you with eyeglass repairs or replacements.