Holliston Vision Center

841 Washington Street, Holliston, MA 01746

​​​ 508-429-1330
Mon. & Fri.   8 a.m. to 4 p.m.
Tues. & Thurs.   9 a.m. to 4 p.m.
Weds.  9 a.m. to 7 p.m.

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Holliston Vision Center
841 Washington Street, Holliston, MA 01746
Telephone:  508-429-1330

FAX:  508-429-0922
E-mail: drjeunod@gmail.com

E-mail: drlapagliaod@gmail.com


Use the form below to contact us with your general questions! Please do not use this form to schedule or cancel an appointment or for any confidential medical information.

We look forward to seeing you soon!

Patient Instructions & Forms:

FOR NEW PATIENTS:


Notice of Privacy Practices (.pdf) -  Print the last page and bring the signed form to your exam.


Patient History Form (.doc) -   Fill this out and bring it to your appointment.  This provides us with your personal medical history and insurance information.


Patient History Form (.pdf) -  Use this form for PDF format printing.



FOR MEDICARE PATIENTS ONLY:

Medicare does not coverage well-visit routine eye exams.  You will be responsible for all exam fees if you do not have a complaint, such as eye pain, irritation, itching, redness, tearing OR if you are not currently being followed for a known condition such as diabetes, cataracts, glaucoma or macular degeneration.  


Medicare does not cover a refraction -- Refraction is the process required to determine your best corrected vision which is integral in determining ocular health.  Refraction is also used to establish a prescription for eyeglasses.  You will be responsible for this fee.


Medicare Authorization Form(.doc) -  Print this form, fill this out and bring it to your appointment.



FOR NEW AND EXISTING PATIENTS (IF NEEDED):


Record Release Form ​(.doc) - This enables us to secure information from your previous or existing eye doctor. 

How to find our office:



Patients under the age of 18 must be accompanied by a parent or legal guardian.


Please arrive 15 minutes early to fill out paperwork.  You can also find our patient forms further below.  To save time, you can fill them out at home and bring them with you.


Bring your insurance card to each visit.  For those without insurance, payment is due at the time of services.


Please wear your contact lenses to your exam and bring your care solutions and eyeglasses.  Contact lens wearers who are new to our office should also bring their contact lens prescription or old contact lens boxtop for parameter and brand identification purposes.


Prepare to have your eyes dilated.  A dilated eye exam allows us to do a complete exam of the retina.  It is important to do it throughout your life, as several eye diseases and conditions (e.g. diabetes, high blood pressure, macular degeneration, glaucoma) are detected at their earliest stages during a thorough eye exam.  


The dilating drops may last on average, 4-6 hours before they wear off. Occasionally, we use longer lasting eye drops in younger children, which can last approximately 24 hours.


Most people feel comfortable to drive after their pupils have been dilated. However, if you have never had your pupils dilated before (and therefore don't know if you will feel safe or not), we recommend that you bring a driver or arrange for someone to pick you up after your exam. People generally have the most difficulty focusing for near work (reading and/or computer work) until the dilation wears off.


You will also be light sensitive as long as your pupils are dilated. Sunlight (any bright light) will not harm your eyes, but it feels uncomfortable. If you forget to bring your own sunglasses, we can give you disposable sunglasses for your comfort.


WHAT IS THE DIFFERENCE BETWEEN A "VISION EXAM" AND "MEDICAL EYE EXAM"?


A "vision exam" is considered a well-visit eye exam and is often called a "routine exam".  The exam usually includes dilation of the pupils, and refraction which determines a person's best vision and whether or not a they require an eyeglass prescription.  For some patients, this type of exam may be covered by a vision plan which is separate from the general health insurance plan.  We cannot guarantee coverage for services under your insurance or vision plan.  You are responsible for calling your insurance Member Services to determine your eligibility and coverage.  


A medical eye exam, covered under general health insurance, is done when the patient has a main complaint such as eye irritation, pain or known conditions such as diabetes, glaucoma, cataracts, etc.  Specialized medical eye testing, such as visual field exam and retinal photography, are considered medical tests and are billed to your general health insurance.  A Refraction is, unfortunately, generally NOT considered a covered service under medical insurance plans.  We cannot guarantee coverage for services under your insurance.  You are responsible for calling your insurance Member Services to determine your eligibility and coverage.