Avoid The Wait - Fill out our patient forms before arriving

8907 Warner Avenue #125
Huntington Beach, CA 92647
(714) 962 - 6400

HEALTHY EYE CENTER FAMILY OPTOMETRY
Johan Tran, Ph.D., O.D. &
Deric C. Simmons, O.D.

At Healthy Eye Center, we understand how important your time is. Whether you are making an eye examination appointment to see our doctors, or just planning out your day, every minute matters. That's why we want to make the process of keeping your patient records up to date as easy and painless as possible.

Whether you are a new patient or an existing patient, if you know that we are missing some critical pieces of your medical history or insurance information, please be sure to download and print out the forms below and bring them in when you schedule your next appointment.

Patient Forms

Having them ready to go will save you time waiting to be seen, so you can get back to your day! If you have a question about a particular piece of information on any of the forms, just leave it blank and ask us about it when you arrive, or simply give us a call at (714) 962 - 6400 and our friendly staff will be more than happy to assist you.

To better serve our patients, and make our waiting times as short as possible, we have put important web forms online here at our website. Please print the form below, fill it out and bring it into our office at the time of your appointment.

Thank you in advance for your assistance!

Check-In Form (7KB)