(416) 971-8355

Toronto Eaton Centre

(416) 798-8908

Woodbine Centre

(416) 466-6670

Broadview Eyecare

Excellence in vision care since 1983

INSURANCE CONSENT FORM: WOODBINE MALL 

Insurance Direct Billing Consent Form:


This form must be filled out when insurance claims are submitted electronically by Dr. Archie Chung & Associates Optometrists at Woodbine Mall (Woodbine Mall, 500 Rexdale Blvd., Unit D014,Rexdale, ON M9W 6K5) on the patient’s behalf and retained for two years in the patient file following closure of the patient file.

EXPERIENCING TECHNICAL DIFFICULTIES? PLEASE DO NOT WORRY!

If you can not complete our insurance consent form because you're currently experiencing any technical difficulties, please do not worry! Please inform our clinic of any challenges. We can also assist you directly in clinic. We are always striving to improve. If you have any questions or concerns, please contact us. Thank you.

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