New Patient

New Patient Form


Welcome! If you’re planning your first visit to Ark Valley Vision Care, we look forward to meeting you. To save time on your first visit, we encourage you to print and fill out our new patient forms below.

If you do not already have AdobeReader® installed on your computer, Click Here to download.

  • Download the necessary form(s), print it out and fill in the required information.

  • Complete your forms and bring them in with you to your appointment
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EMpeK@124 none 8:00 AM - 6:00 PM 9:00 AM - 5:00 PM 9:00 AM - 5:00 PM 9:00 AM - 5:00 PM 9:00 AM - 5:00 PM Closed 9:00 AM - 6:00 PM optometrist # # # https://s3.amazonaws.com/static.organiclead.com/Site-722c5ca7-1e4a-42e1-b98f-a31c19d35d6d/ArkValley_Q4_SeasonOfSavings_socialpost.png https://s3.amazonaws.com/static.organiclead.com/Site-722c5ca7-1e4a-42e1-b98f-a31c19d35d6d/ArkValley_Q4_SeasonOfSavings_webtile.png Enable https://s3.amazonaws.com/static.organiclead.com/Site-722c5ca7-1e4a-42e1-b98f-a31c19d35d6d/ArkValley_Q1_SeeTheDifference_webtile.png https://s3.amazonaws.com/static.organiclead.com/Site-722c5ca7-1e4a-42e1-b98f-a31c19d35d6d/ArkValley_Q2_SpringIsInSight_webtile.png https://s3.amazonaws.com/static.organiclead.com/Site-722c5ca7-1e4a-42e1-b98f-a31c19d35d6d/ArkValleyVisionCare_Q3_PateintAppreciation_WebtileROYA.png https://s3.amazonaws.com/static.organiclead.com/Site-722c5ca7-1e4a-42e1-b98f-a31c19d35d6d/ArkValley_Q4_SeasonOfSavings_socialpost.png 7193830134 7194041825 302 West 3rd Street
La Junta, CO 81050-1430 ljstaff@arkvalleyvision.com 8:00 AM - 6:00 PM 8:00 AM - 6:00 PM 10:00 AM - 6:00 PM 8:00 AM - 6:00 PM Closed Closed Closed https://www.facebook.com/BallantyneVisionCareLaJunta https://www.instagram.com/arkvalleyvisionlajunta/ https://www.google.com/search?q=Ballantyne+Vision+Care,+302+W+3rd+St,+La+Junta,+CO+81050,+USA&ludocid=10680341410348907198 https://g.page/r/Cb66vQPtMTiUEAg/review 7193363311 7194961034 1607 South Main Street
Lamar, CO 81052 lmstaff@arkvalleyvision.com 8:00 AM - 6:00 PM 8:00 AM - 6:00 PM 9:00 AM - 6:00 PM 8:00 AM - 6:00 PM Closed Closed Closed https://www.facebook.com/BallantyneVisionCareLamar https://www.instagram.com/arkvalleyvisionlamar/ https://www.google.com/search?ei=UQMmXcnECoqUgAanrqbIDg&q=Ballantyne+Vision+Care%2C+1607+S+Main+St%2C+Lamar%2C+CO+81052&oq=Ballantyne+Vision+Care%2C+1607+S+Main+St%2C+Lamar%2C+CO+81052&gs_l=psy-ab.3...43045.43045..44401...0.0..0.228.228.2-1......0....2j1..gws-wiz.G1JWEQIdkoQ https://g.page/r/CdnYyNhvXZFjEAg/review