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Contact
Brussels Eye Doctors > Contact

Contact

  • ADDRESS

    • Address

    Brussels Eye Doctors

    Boulevard Saint-Michel, 12-16

    1150 Brussels (Woluwe Saint-Pierre)

    Belgium

  • CONTACT FORM

    • Contact form

    If you have any questions, if you wish to obtain further information, do not hesitate to contact us using the form below.

    Simply state if your question is a general one or if it is a medical question. In this case, we will ask you to provide us with some medical information which will enable us to give a better answer to your question.

    Any information you send us is, of course, covered by medical confidentiality.


    FIRST NAME
    NAME
    PHONE
    E-MAIL
    MESSAGE
    What is your age?
    Do you wear glasses?
    Do you know the correction of your glasses?
    RIGHT EYE
    Sphere (in diopters)
    Cylinder (in diopters)
    Axis (in case of astigmatism)
    LEFT EYE
    Sphere (in diopters)
    Cylinder (in diopters)
    Axis (in case of astigmatism)
    Do you wear contact lenses?
    Do you know the correction of your contact lenses?
    RIGHT EYE
    Sphere (in diopters)
    Cylinder (in diopters)
    Axis (in case of astigmatism)
    LEFT EYE
    Sphere (in diopters)
    Cylinder (in diopters)
    Axis (in case of astigmatism)
    How many years do you wear contact lenses?
    What type of contact lenses?
    How do you tolerate your contact lenses?
    Additional information

    The form contains errors; please correct them.

BRUSSELS EYE DOCTORS, BD SAINT-MICHEL 12-16, 1150 BRUSSELS – TEL. + 32 2 741 69 99