(310) 208-3011 staff@villageeyes.com

Patient Forms

Welcome to Village Eyes Optometry

To help us save you time on your visit, please download these forms and after filling them out either bring them into the office for your appointment or scan and send them to staff@villageeyes.com prior to your appointment.

Welcome to Village Eyes: Patient Registration Form

Village Eyes Optometry HIPAA – Notice of Privacy Practices

Billing and Financial Policies & Insurance Authorization and Assignment