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  • HOME
  • OUR PRACTICE
    • Dr. Gemma S. Stirba, O.D.
    • Dr. Paul R. Shepherd, O.D.
    • Dr. Bethany Arabic, O.D.
    • Our Staff
    • Dr. James L. Boccuzzi, O.D., F.A.A.O. (Retired)
  • SERVICES
    • Glaucoma Management
    • Diabetic and Hypertension Examination
    • Dry Eyes
    • Meibomian Gland Dysfunction (MGD)
    • Allergies
    • Macular Degeneration Treatment
    • Refractive Surgery Consultation
    • Cataract Evaluation and Management
    • High Risk Medications Examination
    • Emergency Care
    • Contact Lens Fitting
    • InfantSEE
  • OPTICAL
    • Spectacle Lenses
    • Designer Eyewear
  • CONTACT LENSES
  • TECHNOLOGY
    • Technology: Glaucoma Management
    • Technology: AVISO Ultrasound Platform UBM and A/B Scan
    • Technology: Macular Degeneration Management
    • Technology: Konan Specular Microscope
    • Technology: Corneal Topography
  • OFFICE INFO/FORMS
    • Office Info & Policies
    • Patient Forms

PATIENT FORMS

Patient Formsdavid@missionbranding.com2025-12-24T19:39:14+00:00

Killingly Eye Care: Patient Forms

View/download New Patient Questionnaire (Adult) >

View/download New Patient Questionnaire (Child) >

View/download Three Year Update Medical Questionnaire >

OFFICE HOURS

Monday: closed
Tuesday: 8a-1p/ 2pm–6p

Wednesday: 8a–1p/ 2p-5p

Thursday: 8a-1p/

2p–5p

Friday: 8a–4p
Saturday: 8a–12 noon
Sunday: closed

Follow Us:

OPTICAL SHOP HOURS

Monday: closed
Tuesday: 8a–12:30p/

2p-5:30p

Wednesday: 8a–12:30p / 2p–4:30p

Thursday: 8a–12:30p/ 2p-4:30

Friday: 8a–3:30p
Saturday: 8a–11:30a
Sunday: closed

CONTACT US

T 860-779-1588
F 860-779-1754
killinglyeyecare.com
24 Hours Medical Emergency Care Only:
860-942-6585

Otherwise, please call our office during office hours for other inquiries

FIND US

KILLINGLY EYE CARE
25 Green Hollow Road
Danielson, Connecticut 06239

© Copyright 2025 Killingly Eye Care  |  All Rights Reserved

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