GORDON W JENNINGS OD PC, FAMILY EYE & VISION CARE
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  • Our OD's
  • Services
    • Patient Forms
    • Request Appointment
    • Order Contact Lens
  • Insurance
    • In-Network Insurance Carriers
    • No Vision Insurance?
  • Optical Shop
    • Promotions
  • Contact Us
  • COVID-19

Patient Forms

Click the links below to download and print out our Patient Forms before your visit with us.
Patient Information & History
Office Policies
Patient Authorization
OR
​
​Complete forms online by using our patient portal (integrated forms) below

Integrated forms


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Gordon W. Jennings, OD
Scott R. Brandau, OD
310 East Main Street
Wytheville, VA 24382
Phone: 276-228-2771

Monday:  8:00 am - 5:00 pm
Tuesday:  8:00 am - 5:00 pm
Wednesday:  Alternate
Thursday:  8:00 am - 5:00 pm
Friday:  8:00 am - 5:00 pm
Notice of Privacy Practices
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Website by Eyefinity
  • Home
  • Our OD's
  • Services
    • Patient Forms
    • Request Appointment
    • Order Contact Lens
  • Insurance
    • In-Network Insurance Carriers
    • No Vision Insurance?
  • Optical Shop
    • Promotions
  • Contact Us
  • COVID-19