Vallejo · Est. 2003
Optometry.
Vallejo
HIPAA · Secure portal

Save timebefore you arrive.

Complete patient forms ahead of your visit through our HIPAA-compliant portal. The appointment starts on time and we can focus on your eyes, not paperwork.

HIPAA Compliant Submission
All forms are completed through a secure third-party patient portal. This website does not collect medical information — protected health information is handled exclusively through our HIPAA-certified intake system.
Three forms · Different audiences

What we need.

Most patients only complete the New Patient and Office Policies forms. Pediatric history is required only for patients under 18.

01
First-time visitors

New Patient Intake

Demographics, contact, vision and medical history. Required before your first visit — completing it ahead of time saves 20–30 minutes in the waiting room.

02
Children & teens

Pediatric History

Birth history, developmental milestones, school performance, and family eye history. Helps us identify learning-related vision issues early.

03
All patients

Office Policies

Acknowledgment of HIPAA practices, financial responsibility, and privacy notices. Required for all new patients per state and federal law.

Access the secure portal

Complete forms through our
HIPAA-compliant portal.

We'll send you a link by email after booking. If you haven't received it 24 hours before your visit, call us and we'll resend.

Day of your visit

What to bring.

Bringing the right items helps us deliver better care — and saves time in the chair so we can focus on what matters.

01

Completed forms

Print or open them on your phone. Both work.

02

Insurance card

Vision and medical, if separate. Photos are fine.

03

Current glasses

Including readers, sun, and any backups.

04

Contact lens info

Brand, base curve, power. The box label has it all.

05

Medication list

Prescription and over-the-counter — including dose.

Questions? Call us.

Our team is happy to walk you through the forms and answer any questions about insurance, scheduling, or what to expect during your visit.