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Welcome to the Hollywood Vision Center.
Please call our office at (323) 954-5800 to schedule an appointment.
If this is your first visit, please fill out the forms below. This will save time at our office because we will have your chart ready, and we can
check your insurance eligibility before your visit to our office.
 All of our forms are available in both Microsoft Word 97 format
and Adobe Acrobat Reader 4.0. Please download the forms and fax them back to our office at (323) 954-5807 or bring them with you to your first appointment.
If you are new to our office, fill out our New Patient Form. Also, please complete this form if you address or health history has changed.
Please read and sign our Financial Policy so you understand your relationship between your employer, your insurance company, and us.
Please complete our Symptoms Checklist for your patient profile.
If you are a contact lens wearer, or are interested in wearing contacts, please also complete our Contact Lens Questionnaire.
If you would like to order special effects contact lenses and already have an optometrist, please have your doctor complete our Special Effects Contact Lens Referral form.
We look forward to seeing you.
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