At Family Eyecare of Glendale, we value your time. In an effort to save you time in our office, you can download and complete our patient form(s) prior to your appointment.
- You will need AdobeReader® to download and complete the forms. Click here to download.
- Download the required form(s). Print out the form(s) and complete the required information.
- Fax your printed and completed form(s) to our office or bring them with you to your appointment.
IMPORTANT INFORMATION ABOUT YOUR APPOINTMENT
MAKING YOUR APPOINTMENT:
1. Check to see if you have any vision benefits with your insurance company or employer. Your exam may be covered. Be sure to give the receptionist the proper insurance information which includes the full name, date of birth, and member ID number for the primary insured.
2. Many medical insurances provide annual eye health evaluations. Please bring your medical insurance card.
3. Check our office hours, location, and map which are available here on our website.
WE INVITE YOU TO BEGIN YOUR REGISTRATION AS A PATIENT BY FOLLOWING THESE DIRECTIONS:
1. Download the Patient Forms
Print your forms, fill them out, and bring to your appointment. Click below to access your patient forms:
- Patient Information Form
- Medical Information Form
- One-time credit card authorization form
2. Prepare for Your Office Visit
In addition to completing the forms, we also require the following information for your visit:
* Driver's License or Other Valid Government Issued Photo Identification
* Insurance cards
* Bring your Glasses
* A List of all Current medications you are taking
* BRING the DROPS you are taking for any eye condition
If you are a contact lens wearer
* Wear your contact lenses for the examination
* BRING the SOLUTIONS you are using for your Contact Lenses
* Bring your information about your contact lenses or the BOXES
3. WE LOOK FORWARD TO SEEING YOU.
Please arrive 15 minutes early if you have not filled out these forms. If you have completed forms with you, you only need to check in with the reception desk 5 minutes before your scheduled appointment.
Thanl you for your assistance completing this information. We look forward to seeing you on your day of your appointment!