Skip to main content

Our Location ccc |

Call 705-503-3937

Hours & Location
Our Eye Doctors
Eye Care Services
Eyeglasses
Contact Lenses
Insurance

Hours & Location
Our Eye Doctors
Eye Care Services
Eyeglasses
Contact Lenses
Insurance

Return to top of menu

Schedule Appointment

Home » Contact Us » OHIP Fee Consent Form

OHIP Fee Consent Form

Diagnostic Services*
- Retinal Imaging
- Ocular Coherence Tomography (OCT):
- Meibomian Gland Expression and Scaling
OHIP*
OHIP number and Version code (2 letters)
Consent
I hereby consent to payment for my visit for the services out- lined above
Name
First Last
Date
MM slash DD slash YYYY
Signature

Δ

Search:

Schedule An Eye Exam

Little Lake Family Eye Care

11 Lakeside Terrace #102
Barrie, ON L4M 0H9

Phone: 705-503-3937
Email: info@littlelakefamilyeyecare.com
(Do not send personal health information by email.)
Email: littlelakefamilyeyecare@gmail.com
(Do not send personal health information by email.)

Monday: 9:00 AM - 4:30 PM
Tuesday: 10:00 AM - 6:00 PM
Wednesday: 9:00 AM - 4:30 PM
Thursday: 9:00 AM - 4:30 PM
Friday: 9:00 AM - 3:00 PM
Saturday: Closed
Sunday: Closed

Home
Contact Us
What’s New
Disclaimer
Privacy Policy

Home
Contact Us
What’s New
Disclaimer
Privacy Policy

Schedule Appointment

Speak Field

Little Lake Family Eye Care
11 Lakeside Terrace #102
Barrie, ON L4M 0H9
Phone: 705-503-3937
https://www.littlelakefamilyeyecare.com

© 2026 Powered by

Accessibility
Sitemap
Privacy
Disclaimer
Login

Schedule Your Appointment