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740 Boston Plaza

Danville, AR 72833 USA

(479) 495-3937

214 E 4th St.

Russellville, AR 72801 USA

(479) 968- EYES (3937)

Online Forms

At Scott & Morden Eye Clinic, we value your time. In an effort to save you time in our office, you can download and complete our patient form(s) prior to your appointment.

  • You will need AdobeReader® to download and complete the forms. Click here to download.
  • Download the required form(s). Print out the form(s) and complete the required information.
  • Fax your printed and completed form(s) to our office or bring them with you to your appointment.

New Patient Health History Form – Required

Please complete this form as it lets us know the history and current state of your health. Let us know what questions, concerns, and goals your have regarding your eye health or vision on the form.

Download & Print Form


Download the Free AdobeReader®

Patients Receive 20% OFF Frame with Eyeglass Purchase

Contact Us

Office Hours

Russellville

Monday:

8:00 am-5:00 PM

Tuesday:

8:00 am-5:00 PM

Wednesday:

8:00 am-5:00 PM

Thursday:

8:00 am-5:00 PM

Friday:

8:00 am-5:00 PM

Saturday:

Closed

Sunday:

Closed

Danville

Monday:

Closed

Tuesday:

9:00 am-5:00 pm

Wednesday:

Closed

Thursday:

9:00 am-5:00 pm

Friday:

Closed

Saturday:

Closed

Sunday:

Closed