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Located in Winnipeg at the corner of Portage & Sprague

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New Patient Form

  • Welcome to Armstrong & Small Eye Care Centre! If you are a new patient, please fill out the form below. Returning patients may fill out the form to inform us of any changes.

  • MM slash DD slash YYYY
  • Mobile
  • Home
  • Work
  • Mobile
  • Home
  • Work
  • To help save our patients time and money, we direct bill with the following insurance companies. Please bring your insurance card to your appointment if you are insured by one of the following companies:

    • Blue Cross
    • Chambers of Commerce
    • CINUP
    • Cowan Insurance Group
    • Desjardins (payable to patient only)
    • First Canadian
    • Great-West Life
    • Green Shield
    • GroupHEALTH
    • GroupSource
    • Industrial Alliance
    • Johnson Inc.
    • Johnston Group Inc.
    • Manion
    • Manulife
    • Maximum Benefit
    • Sun Life Financial
    • Wawanesa Insurance
  • Max. file size: 31 MB.
  • While we are happy to submit a claim to your insurance on your behalf, we are unable to verify insurance benefits prior to your examination or eye wear purchase. We ask that you contact your insurance company in advance to confirm your eye care coverage and eligibility. Please note that certain plans for the above insurance providers do not allow direct billing, and in some cases, submission by the patient is required. Patients are responsible for any amount not covered by their insurance.