Grisnik Eye Care
About us
Location and Hours
For Appointments
Of Interest...
Insurances
Optical Services
For appointments:
Call 412-233-3225
or fill out the form below for assistance.
Have you been examined by Dr. Grisnik before?
*
No, I am a new patient.
Yes, at his Clairton office
Yes, at Associates in Ophthalmology office
Yes, at a nursing home
Please complete an appointment request in the form below. Our office will be in touch with you within 2 business days to confirm an appointment with Dr. Grisnik. Thank you and we look forward to seeing you.
*
If you are having pain in the eye or experiencing sudden vision loss
DO NOT USE THIS FORM
to request an appointment. Please call our office at 412-233-3225 so we can help you in a more timely manner. *
Name
*
First
Last
Is this appointment for you or a family member?
*
myself
spouse
child
Best Phone Number to reach you at:
*
Can we leave a message for you at this number?
*
Yes
No
Email
*
Which day of the week works best for you?
*
Monday (appointments from 9:30am -5:30pm)
Wednesday (appointments from 8:30 am - 2:00 pm)
Friday (appointments from 8:30 am - 2:00 pm)
Saturday (appointments from 8:00 am to noon)
Please tell us what date(s) and time(s) works best with your schedule?
*
Reason for visit?
*
Need new eyeglasses
Need new contact lenses
Blurry vision when driving or reading.
I have health issues (such as diabetes, high blood pressure, etc.) and have been told I need to have regular eye exams.
I have exisiting eye problems (such as glaucoma, cataracts, macular degeneration, etc.) that require regular monitoring by an eye doctor.
Medical Insurance?
*
Vision Plan?
*
How did you hear about our office?
*
friend
family member
primary care doctor
specialist
internet search
insurance company listing
Other
Do you have other family member who will need appointments?
*
yes, spouse
yes, children
no
Comment
*
Submit
(888) 780-6303
Patient Survey
How did you hear about our office?
*
Internet Search
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Family or friend
Referral from another doctor
Pharmacist
When was your last eye exam?
*
Less than a year ago
More than a year ago
About 2 years ago
More than 2 years ago
When I was a child
Never
Do you have a insurance coverage for vision exams, glasses and contact lenses?
*
Yes
No
Not sure
Submit