Residency Manual

EQUIPMENT AND SPACE AVAILABLE

Number of exam lanes: _________________________ Number of optometry exam rooms (other than exam lanes): ________________

Equipment available (include exam room equipment, ancillary equipment, specialty equipment): EQUIPMENT TYPE/SPECIFY/NUMBER

OPERATING HOURS

Day

Time

Day

Time

Monday Tuesday

_________________ _________________ _________________ _________________ _________________

Saturday Sunday

______________ ______________

Wednesday Thursday

Friday

On Call Hours/Time: ____________________________________________________________________________ MULTI-DISCIPLINARY HEALTH SERVICES If the optometry clinic is part of a larger, multi-disciplinary health facility, indicate which other services are provided in the clinic: Specialty Medicine Clinics: Psychology Diabetes Psychiatry Hypertension Neurology Respiratory (describe) Geriatric medicine Dispensing pharmacy Rehabilitative medicine __ Cardiovascular General practice medicine ___Podiatry Internal medicine ___Other (list below) Dentistry

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