Dr. Jeffrey S. Kenyon, Dr. Andrea F. Odle
& Dr. Elizabeth R. Wassenaar


385 Mendon Road, Woonsocket, RI 02895

Patient Forms

Thank you for scheduling an appointment at Blackstone Valley Eye Care.  Please click on the link below to download and print our patient form.

Patient Form

Please remember to bring the following items to your eye exam:

  • Vision and Medical Insurance Card
  • Picture ID
  • Current Eyeglasses
  • Current Contact Lens Prescription
  • List of Current Medications
  • Completed Patient Form (link above)