310.882.6365 Menu

Patient Forms

New Patient Forms

The following forms can be downloaded to your computer and printed at home. Carefully preparing these forms in advance will greatly increase the efficiency of your Consultation and the information it provides you.

  1. New Patient Questionnaire (select one)
    1. Vision Correction Questionnaire
    2. Cataract Questionnaire
    3. General Medical Questionnaire
  1. Financial Policy

Please review the following form. You do not need to print it. We will have a copy for you to sign in our office. If you have any questions, our staff will be happy to answer them in advance of your appointment.

  1. Physician-Patient Arbitration Agreement

If you are interested in our privacy practices, click below:

  1. HIPAA Notice of Privacy Practices

Follow Us On Instagram



Rate Us!

Please take a moment to rate your experience
with our team.

Facebook logo Google+ logo Yelp logo Website logo

Accessibility: If you are vision-impaired or have some other impairment covered by the Americans with Disabilities Act or a similar law, and you wish to discuss potential accommodations related to using this website, please contact our Accessibility Manager at 310.882.6365.

Schedule a Consultation