Order Contacts contact Us
Teagle Family HistoryValencia StoreGlendale StoreLasikOptomapWhy do I Have Red Eyes?The History of Eyeglasses
 
 
Please fill out the form below to schedule an appointment at the Valencia Store:
(To schedule an appointment at the Glendale store, click here )
 


Full Name:  

Date Of Birth: 

New Patient    Previous Patient

Insurance Name: 

Social Security# of the primary insurance carrier: 

Daytime Telephone Number: 

 

The Teagle Family | Valencia Store | Glendale Store | Lasik Surgery | Optomap Scan | Have Red Eyes?
History of Glasses | Appointments | Order Contacts | Contact Us

© 2007 Teagle Optometry | Privacy Statement | Web Design by Compu-Eze