| 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. 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 (661) 327-4499 for assistance or email us your questions at info@goldenstateeye.com.
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:
- New Patient Information. This form is required for all new patients
- Patient History. This form is required for all new patients
- Acknowledgement of HIPAA. Please read our Notice of Privacy Practices below and sign this Acknlowledgement.
- Notice of Privacy Practices. Please read this Notice and sign the Acknowledgement (above). This important notice tells our patients how we utilize their protected health information in accordance with the Health Insurance Portability and Accountability Act (HIPAA).
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