Form Instructions

Once you have scheduled your appointment, please complete the Patient Registration and Health History Questionnaire Forms.

Return the forms to us prior to your appointment. This will speed-up the new patient registration process.

  • Complete the Patient Registration Form
  • Complete the Patient Medical History Form
  • Send the completed forms to us by US Mail or Fax.

Due to our commitment to privacy, we ask that you DO NOT send us completed forms through email.

Fax Forms

Download the fax cover sheet, then fax your completed forms, with the cover sheet, to the following number:

(408) 358-8999

Mail Forms

Mail your completed forms to the following address:

South Bay Ophthalmology
2505 Samaritan Drive, Suite 408
San Jose, California 95124

Please read our Welcome Letter to learn what to expect on the day of your visit and what you should bring with you.

Thank You!

We look forward to meeting you in person!