Patient Forms: Please present these completed forms, ID, and Insurance cards during check-in.
- Adult Medical Questionnaire
- Pediatric Medical Questionnaire
- New Patient Information
- Authorization For Release of Medical Records: Please submit this form with your current provider so we can review your history before the appointment.
- HIPPA and Payment Policy
- Insurance Disclosure Form
- Order contact lens
Referral Process: If your insurance require referral prior seeing a specialist, please request your primary care physician (PCP), optometrist, and other referring physicians, nurses, clinics to complete the Referral Form.
Questions to Clinical Staff: Patient portal can be used to send secured messages to the clinical staff. Original Login credential: LASTNAMEPatientID, Password:TranMMDDYYYY. Please contact staff to obtain PatientID. For example: SMITH202118, Password: Tran01012018. The patient last name is Smith, patient ID is 202118, and patient birthday is on January 01, 2018. Patient Portal Link
Rx Prescription: Please request your pharmacist to fax request to 888-959-8367. We can not accept phone prescription request.
Release of Medical Records: If you need a copy of your clinical records, please have the requesting physician fax the following form to 888-959-8367: Authorization For Dr. Tran to Release Medical Records.