Connersville Location

765-377-1241

Rushville Location

(765) 377-1241

Online Forms

At Yaryan Eye Care Center, we value your time. In an effort to save you time in our office, you can download and complete our patient form(s) prior to your appointment or fill out the form below to be emailed to our office.

  • You will need AdobeReader® to download and complete the forms. Click here to download.
  • Download the required form(s). Print out the form(s) and complete the required information.
  • Fax your printed and completed form(s) to our office or bring them with you to your appointment.

New Patient Health History Form – Required

Please complete this form as it lets us know the history and current state of your health. Let us know what questions, concerns, and goals your have regarding your eye health or vision on the form.

Downlad & Print Form


Download the Free AdobeReader®

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Our Locations

HOURS OF OPERATION

Connersville Location

Monday

9:00 am - 5:00 pm

Tuesday

8:30 am - 7:00 pm

Wednesday

8:30 am - 7:00 pm

Thursday

8:30 am - 5:00 pm

Friday

8:30 am - 5:00 pm

Saturday

Closed

Sunday

Closed

Brookville Location

Monday

Closed

Tuesday

8:30 am - 5:00 pm

Wednesday

9:00 am - 5:00 pm

Thursday

9:00 am - 7:00 pm

Friday

8:30 am - 5:00 pm

Saturday

Closed

Sunday

Closed

Rushville Location

Monday

9:00 am - 7:00 pm

Tuesday

Closed

Wednesday

8:30 am - 5:00 pm

Thursday

9:00 am - 7:00 pm

Friday

9:00 am - 5:00 pm

Saturday

Closed

Sunday

Closed

Connersville Location

Monday
9:00 am - 5:00 pm
Tuesday
8:30 am - 7:00 pm
Wednesday
8:30 am - 7:00 pm
Thursday
8:30 am - 5:00 pm
Friday
8:30 am - 5:00 pm
Saturday
Closed
Sunday
Closed

Brookville Location

Monday
Closed
Tuesday
8:30 am - 5:00 pm
Wednesday
9:00 am - 5:00 pm
Thursday
9:00 am - 7:00 pm
Friday
8:30 am - 5:00 pm
Saturday
Closed
Sunday
Closed

Rushville Location

Monday
9:00 am - 7:00 pm
Tuesday
Closed
Wednesday
8:30 am - 5:00 pm
Thursday
9:00 am - 7:00 pm
Friday
9:00 am - 5:00 pm
Saturday
Closed
Sunday
Closed