Patient Forms

Please fill out the following patient information forms and bring them with you to your first visit. Signing "Acknowledgment of Receipt of Privacy Practices" on the form signifies that you have read the Privacy Policy, listed below.

• Medical History Form
• Finance Policy
• History​
• Procedure Waiver / Consent Form

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Promotions

​Prescription glasses for cash.
Recycle your old prescription glasses for credit towards a new pair!  Trade in your old prescription glasses for $129 credit towards your purchase of new prescription eyeglasses. The credit applies to complete pairs only (excludes true value package) and cannot be used with any insurance or discount plan.
 
Expires 10/31/2018

Click below to Reorder your contacts on line with our contact lens service:

You will find our prices very competitive and, in many cases, our prices are even lower than many online merchants. Best of all, by ordering your contacts on our secure web store, you help support our local community and keep your dollars in Nevada County. Check it out. Please contact our office if you need to order any specialty lenses, such as gas perm (RGP), bifocal, or kerataconic lenses not listed in our web store. These lenses are available directly through our office.

Please call or e mail our office for pricing