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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 Advertisement 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

For appointments: Call 412-233-3225 or fill out the form below for assistance.

Patient Survey

For appointments:
Call 412-233-3225
or fill out the form below for assistance.