Patient Info

Feel free to print these forms to complete and bring in with you to your appointment to help speed up your office visit:

Welcome Form – only needs to be completed once per year. If you’ve already visited the office in 2020, you don’t need to do this again until 2021.

COVID-19 Consent Form – This needs to be filled out at EVERY office visit you make. Please leave temperature and time fields blank. We will take your temperature when you arrive at the office.


Caring for your vision doesn’t begin and end with eyeglasses, contact lenses, and corneal modification  surgeries like Lasik. There are many things you can do to maximize and protect the visual tools you currently have.

Several studies have shown that a diet high in the nutrients lutein and zeaxanthin can help prevent sight-robbing diseases like macular degeneration and cataracts.

In addition to eye diseases like glaucoma and diabetic retinopathy, visual trauma, like bruises and cuts to the eye, often result in permanent vision loss.

Fortunately, many of these injuries are preventable. Regular use of eye protection on the job, working around the house, and playing sports can prevent up to 90% of ocular injuries. To assist in preventing these injuries, the American Optometric Association developed the Occupational Vision Manual to assist employers and employees in keeping workplaces safe.

There are other preventable dangers that can build over time. Patients can struggle with Computer Vision Syndrome and over-exposure to ultra-violet rays. Over 10 million U.S. children suffer from undetected vision problems, even when they pass a school vision screening, adversely affect their school performance.

As important as these tips are, an essential component of healthy vision is a regularly-scheduled comprehensive eye examination. Optometrists are specially trained to detect and treat problems and conditions of the eye, and can help you get the most from your vision.

The American Optometric Association offers a wealth of information on everything from eye exams to eye diseases and conditions.

American Optometric Association


Middlebury Eye Associates, Inc.

Middlebury Eye Associates, Inc.  Office Policies

*Payment-we accept cash, check, all major credit cards. We also offer a payment plan through Care Credit.   A $25 returned check fee will be added to your account for any returned checks.

*Appointments –Your scheduled appointment has been reserved specifically for you. We request 24 hour notice if you need to reschedule your appointment. We are aware that unforeseen events sometimes require missing an appointment. Please inform us as soon as possible if you are unable to keep your appointment.

*Late arrivals-If you arrive more than 15 minutes late for appointment you may be asked to reschedule.

*What you should bring to your appointment. Please bring your current insurance card, current pair of prescription glasses/ sunglasses, and a current medication list.  If you are a contact lens wearer, please wear your current contact lenses into the appointment and bring your contact lens prescription and/or your contact lens boxes with you.

*Emergencies-Same day appointments are usually available for urgent or sudden illness/injury. We do everything in our power to see a patient that calls or arrives in our office needing to be seen. Patients given same day appointments should expect increased waiting times in the office.

*After Hour Emergencies-Please call our on call service 1-802-350-2106.  One of the providers should be available to triage the call and determine how quickly you need to be seen.

*Eyeglass prescriptions are only valid for two years.  After that they are considered expired and cannot be filled.

*Contact Lens prescriptions are valid for one year.  Expired prescriptions are invalid and will not be filled. Contact lenses are medical devices.  They are FDA approved and need to be fit and monitored to keep the cornea healthy. The amount of lenses you will be able to order is a years’ worth.

Our office recommends following your doctor’s advice for wear time, replacement schedule and care of your contacts. Our office does not recommend sleeping in contacts lenses, unless expressly directed by your doctor. To minimize contamination and risk of infection it is NOT recommended to swim, shower, or use a hot sub or sauna with contact lenses in your eyes.

It is important to have a yearly exam to monitor corneal health and assess the fit of your contact lenses. Contact lenses will only be filled with the brand and type of contact lens prescribed.  No substitutions allowed.  Over wear or using lenses longer than intended can adversely affect your eye health.  Any problems while wearing contact lenses, including but not limited to pain, redness, discharge, change in vision would be important to call our office for evaluation.

At Middlebury Eye Associates, Inc. we appreciate you trusting us with your eye care and eyewear needs.  We practice Comprehensive Eye Care, where we treat the overall health of your eye. We believe all our patients should be treated with dignity.  We reserve the right to terminate a patient from the practice in those rare cases when a patient may be verbally or physically abusive to the staff and/or the Doctors, refuse to give necessary information, or is non-compliant with ocular instructions, treatment and advice.

If you have any issues, questions, comments or concerns you may file them with the practice at the following address;

Middlebury Eye Associates, Inc.
Attn: J. Lemner- Office Manager
91 Main Street
Middlebury, Vt  05753