Patient Forms: Please present these completed forms, ID, and Insurance cards during check-in.

1. Adult Medical Questionnaire

2. Pediatric Medical Questionnaire

3. New Patient Information

4. Authorization For Release of Medical Records: Please submit this form with your current provider so we can review your history before the appointment.

5. HIPPA and Payment Policy

6. Insurance Disclosure Form

7. 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.