Cross-linking

All Gimbel Eye Centre patients having corneal refractive procedures are offered Collagen Cross-linking which strengthens the cornea using Riboflavin and ultra-violet light and may be of benefit to everyone.

Request a Complimentary Eye and Vision Assessment

After you submit this form, a Patient Counsellor will contact you to book an appointment for your assessment.

Which Gimbel Eye Centre location would you prefer to contact you?

Salutation:

*First Name:	*Last Name:	Date of Birth:
Address:	City:
Province/State:	Country:

Postal/Zip:

Fax:

*Email:

*Telephone (H):

Telephone (W):

Telephone (C):

Contact me at: Home Work Cell

Best time(s):

Who is your ophthalmologist?

Who is your optometrist?

What do you do for a living?:

Has your eye sight been generally stable for the last year?

Current Eyeglass or Contacts Prescription:
Left:
Right:

Do you wear contact lenses

If you are a contact lens wearer, what type do you wear?

If you answer "YES" to any of these questions, please give us DETAILS in the space provided (if "No" leave blank"):

Do you have health problems with your eyes, have you had a previous eye injury, or have you been diagnosed with an eye disease?

If Yes, please specify:

Have you had previous eye surgery?

If Yes, please specify:

Do you have any health problems?:

If Yes, please specify:

Are you on any medication?

If Yes, please specify:

Do you have any allergies to medication?

If Yes, please specify:

Are you pregnant or nursing, or do you plan to get pregnant within the next year?

If Yes, please specify:

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Vision Correction Options

Gimbel Eye Centre has a variety of vision correction options. Read more, and be sure to visit our library of animated videos.

Are You a Candidate?

Have you been considering vision correction? Read our candidate guidelines.

FAQ

Do you have questions? Read here for answers to the most commonly asked questions about eye surgery.

Events

Gimbel Eye Centre routinely offers seminars and workshops for doctors. Visit our Events page to learn more.

Gimbel Eye Foundation

The Gimbel Eye Foundation was established in 1984, to raise the level of patient care in Canada and around the world. Learn more