Dr. Heloi Stark, O.D., P.C.
Give us a call:
703-698-8880
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Patient Forms


VSP Patient
File Size: 495 kb
File Type: pdf
Download File

Please print and complete these forms prior to your scheduled appointment. These forms are only for participating VSP members. Please bring eyeglasses, contact lenses, contact lens prescription information (boxes or vials), any pertinent medical history/records and these completed forms to your appointment. 

Welcome_to_our_office_pdf.pdf
File Size: 251 kb
File Type: pdf
Download File

Please print and complete these forms prior to your scheduled appointment. These forms are for all new patients (excluding VSP members). Please bring eyeglasses, contact lenses, contact lens prescription information (boxes or vials), any pertinent medical history/records, your vision insurance card (if any) and these completed forms to your appointment.

Welcome_back_to_our_office_3.pdf
File Size: 249 kb
File Type: pdf
Download File

These forms are for all former patients returning to our office (excluding VSP members). Please print and complete these forms prior to your scheduled appointment. Please bring eyeglasses, contact lenses, contact lens prescription information (boxes or vials), any pertinent medical history/records, your vision insurance card (if any) and these completed forms to your appointment.
Contact Us
3031 Javier Rd., Suite 300
Fairfax, VA 22031

Phone: 703-698-8880
Fax:  703-698-8884

Office Hours
Mon    8:00 a.m.- 5:00 p.m.
Tue     8:00 a.m.- 5:00 p.m.
Wed    8:00 a.m.- 5:00 p.m.
Thu     8:00 a.m. - 5:00 p.m.
Fri       8:00 a.m. - 5:00 p.m.


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