Welcome to RDR Optometric Care PA

If you've filled this out in the past, be sure to use the exact same email and spelling of your name, so your previous info can be pre-filled on the form. i.e, Robert not Rob, or vice versa, etc. 

This form is only to be used for followup appointments within 3 weeks of a previous appointment. 

If this is for a regular exam, not a followup within 3 weeks of a previous appointment, please go to https://rdroptometric.com/intake

PLEASE NOTE:  DO NOT COMPLETE THIS FORM MORE THAN TWO (2) DAYS EARLIER THAN YOUR APPOINTMENT TIME OR IT WILL NEED TO BE COMPLETED AGAIN.