Patient Forms

Patient Privacy

Patient FormsAt California Eye professionals our goal is to provide the same medical care to you that we would want to receive ourselves. Our entire staff is held to an exceptional level of integrity in terms of privacy. We want you to know that you can trust us with your eyes and health information. If you have any questions, you can contact our management team at each of our offices.

For your convenience, we have made a number of forms available for patients to download. If you are new to our practice, we encourage you to download and print out the new patient forms. Filling these out in advance of your first visit will minimize the time you spend in the waiting room filling them out when you get here. Please bring these completed forms with you on the day of your visit.

 

Statement of Non-Discrimination

California Eye Professionals complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.

Please bring the following with you to your appointment:

  • Completed new patient forms (download, print and complete)
  • A list of all prescribed medications with dosages and quantity
  • Insurance card(s)
  • A valid photo ID (preferably a Driver’s License)
  • Payment in the form of check, cash, or credit card

Dilation of your Eyes:

Please bring sunglasses with you and a driver if your eyes will be dilated with drops during your eye exam.

Other forms are informational. If your doctor has given you a form with specific information or instructions different from the information on these online forms, rely on the information given to you by your doctor, not on the online forms. If you’re not sure which forms you need, please call 951-652-6100 for assistance or click here to email us your questions.

If you’re unable to open these files, you probably need to download the free Adobe Acrobat Reader program, which is available at the following location: www.adobe.com/products/acrobat/readstep.html

Click on the forms you would like to download:

Patient Registration Forms:

Other Forms:

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