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CALL US 410-939-6477
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  • Home
  • About
    • Optometric Residency & Student Externship Program
    • Clinical Research
  • Doctors
    • Jonathan A. Seidenberg, M.D., F.A.C.S.
    • Eugene E. Protzko, M.D.
    • Candice R. Giordano, M.D.
    • David D. Reed, O.D., F.A.A.O.
    • James E. Stottlemyer, O.D., F.A.A.O.
    • Scott M. Smearman, O.D., F.A.A.O.
    • Daniel C. Byron, O.D.
    • Jessica A. Wieser, O.D.
  • Conditions
    • Cataract
    • Macular Degeneration (AMD)
    • Diabetic Retinopathy
    • Glaucoma
    • Flashes & Floaters
    • Blepharitis
    • Conjunctivitis Pink Eye
    • Corneal Abrasion
    • Dry Eyes
  • Services
    • Eye Exams
    • Cataract Surgery & Lens Implants
    • Glaucoma Diagnosis & Treatment
    • Macular Degeneration Treatment
    • Diabetic Retinopathy Treatment
    • LASIK Laser Vision Correction
    • Pediatric Eye Care
    • Aesthetics & Eyelid Surgery
      • Specials
      • Dysport®
      • Restylane®
      • Ultherapy®
      • BOTOX® COSMETIC
      • JUVÉDERM® XC
      • Pelleve®
      • LATISSE®
      • Skintrinsiq
      • Eyelid Surgery
      • Obagi® Skin Care Products
    • Eyeglasses & Sunglasses
    • Contact Lenses
    • Clinical Research
  • Hours & Locations
    • Bel Air
    • Chestertown
    • Elkton
    • Havre de Grace
    • Mid-Atlantic Surgery Pavilion
  • Resources
    • Flexible Payment Plans
    • Insurance & Financial Policy
    • Patient Forms
    • Order Contact Lenses
  • Clinical Research
SPEA Logo
  • Home
  • About
    • Optometric Residency & Student Externship Program
    • Clinical Research
  • Doctors
    • Jonathan A. Seidenberg, M.D., F.A.C.S.
    • Eugene E. Protzko, M.D.
    • Candice R. Giordano, M.D.
    • David D. Reed, O.D., F.A.A.O.
    • James E. Stottlemyer, O.D., F.A.A.O.
    • Scott M. Smearman, O.D., F.A.A.O.
    • Daniel C. Byron, O.D.
    • Jessica A. Wieser, O.D.
  • Conditions
    • Cataract
    • Macular Degeneration (AMD)
    • Diabetic Retinopathy
    • Glaucoma
    • Flashes & Floaters
    • Blepharitis
    • Conjunctivitis Pink Eye
    • Corneal Abrasion
    • Dry Eyes
  • Services
    • Eye Exams
    • Cataract Surgery & Lens Implants
    • Glaucoma Diagnosis & Treatment
    • Macular Degeneration Treatment
    • Diabetic Retinopathy Treatment
    • LASIK Laser Vision Correction
    • Pediatric Eye Care
    • Aesthetics & Eyelid Surgery
      • Specials
      • Dysport®
      • Restylane®
      • Ultherapy®
      • BOTOX® COSMETIC
      • JUVÉDERM® XC
      • Pelleve®
      • LATISSE®
      • Skintrinsiq
      • Eyelid Surgery
      • Obagi® Skin Care Products
    • Eyeglasses & Sunglasses
    • Contact Lenses
    • Clinical Research
  • Hours & Locations
    • Bel Air
    • Chestertown
    • Elkton
    • Havre de Grace
    • Mid-Atlantic Surgery Pavilion
  • Resources
    • Flexible Payment Plans
    • Insurance & Financial Policy
    • Patient Forms
    • Order Contact Lenses
  • Clinical Research
CALL US 410-939-6477

Patient Forms

New Patient Form (PDF)

Established Patient Form (PDF)

SPEA Medical Records Release Form — Patient Request (PDF)

CALL US 410-939-6477

Bel Air
Phone: 443-643-4500
Fax: 443-643-4510

Chestertown
Phone: 410-778-1150
Fax: 410-778-2949

Elkton
Phone: 410-620-3600
Fax: 410-620-3838

Havre de Grace
Phone: 410-939-6477
Fax: 410-939-6555

Bel Air
P: 443-643-4500
F: 443-643-4510

Chestertown
P: 410-778-1150
F: 410-778-2949

Elkton
P: 410-620-3600
F: 410-620-3838

Havre de Grace
P: 410-939-6477
F: 410-939-6555

Mid-Atlantic Surgery
P: 410-273-9096
F: 410-273-9146

Clinical Research Department
Phone: 443-643-4506
Fax: 410-939-6555

Mid-Atlantic Surgery
Phone: 410-273-9096
Fax: 410-273-9146

Clinical Research Department
Phone: 443-643-4506
Fax: 410-939-6555

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