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East Location 1200 E. Main Street Ste. 3 Spartanburg SC 29307 864 585-7807 www. spartanburgvision.com 227 E. Blackstock Road Ste. I hereby authorize payment from my insurance company to MacMillan Optical. Print Name Date Address SSN. Eye History Why did you schedule your visit today Do you want to be fitted for contacts today Yes / No / Clear / Color Please check any of the following that apply Blurry Distance Vision Blurry Near Vision Double Vision Eye Strain Eye Pain / Soreness Tired Eyes...
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