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Patient Forms

New Patient Forms

The below questionnaire is to be submitted online prior to your appointment. Carefully preparing this form 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

LASIK

LASIK Preparation Guide (pdf 78 KB)
LASIK Aftercare Instructions (pdf 131 KB)

PRK

PRK Preparation Guide (pdf 78 KB)
PRK Aftercare Instructions (pdf 112 KB)

Implantable Contact Lens (ICL)

ICL Preparation Guide (pdf 122 KB)
ICL Aftercare Instructions (pdf 109 KB)

Refractive Lens Exchange (RLE)

RLE Preparation Guide (pdf 110 KB)
RLE Aftercare Instructions (pdf 127 KB)

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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.

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