Book Eye Exam

Use our convenient online form to book an Eye Exam with Glasses To Go, Mobile Vision Care, and choose from the payment options below:

Please mail forms to Glasses To Go with payment to:

Glasses To Go
93 Courtenay Terrace
Sherwood Park, AB T8A 5S6

Or e-transfer funds to

Contact Us

Patient's Name

Patient's Address

Address of where the Patient resides (a Private Residence, Care Centre, or Hospital). *If the Patient is currently living in a Care Centre or Hospital, please indicate on address line 2 which unit/floor/room they are located.
Patients Address
Patients Address

Phone Number

Phone number of Patients residence or room, unit, nursing station, etc.
Location Type

Name of Family Contact/Guardian

Family Contact/Guardian
Family Contact/Guardian
If there is a Public Trustee, please indicate name and phone number
If there is a Public Trustee, please indicate name and phone number
Does the Family Contact/Guardian want to attend the eye exam visit?

Authorization to release medical records including past eye exams to our Optometrist

Type Patient's name or the name of the family contact, guardian or trustee
Do you want to attend the appointments?
Are new frames and lenses required?

Address that the Eye Exam Receipt should be mailed to if other than the Patient's address (eg. the office of the Public Trustee)

Mailing Address for Receipt
Mailing Address for Receipt
Screen Shot 2024 02 09 at 10.28.51 AM Book Eye Exam

Terms of On Site Eye Exam & Service

On site call fee: Includes 2 visits for fitting and adjustments of a complete pair of eye glasses within the first year.

Eye exam policy: 30 days from time of assessment for recheck and lab redo, if required. Frame only is a final sale with no warranty and no exchanges.

Complete order placed but not processed within 30 days of issues receipt are considered final sale with no exchanges or refunds.

Orders cancelled or changes to original order are subject to a restocking fee of 25% and require original receipts to be changed or cancelled. If there is no receipt it is considered a final sale.

Warranty is limited to manufacture defects only. Warranty is of frame and lenses are glued, soldered, have dog teeth marks or any other abuse is done to the original frame or lenses.

Fee Schedule - Please contact our office by phone if you want information regarding our fees. We accept payment by etransfer for our onsite call fee for the eye exam.