Toluca Lake Optometric Center

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  • Home
  • Our Services
  • About Us
  • Eyecare Articles
  • Contact Us
  • Contact Lens Exams
  • Optical
  • Patient Forms
  • Blogs
  • Specialties
  • Diagnostic Equipment
  • Core Services
  • Link Page

Patient Forms

Please complete these forms prior to your appointment and bring them with you.
appointment_check_in___policies_form.pdf
File Size: 59 kb
File Type: pdf
Download File

optos.pdf
File Size: 141 kb
File Type: pdf
Download File

hipaa_1.pdf
File Size: 397 kb
File Type: pdf
Download File

hipaa_2.pdf
File Size: 356 kb
File Type: pdf
Download File

patient_information_questionnaire_new.pdf
File Size: 108 kb
File Type: pdf
Download File

covid_19_px_questionnaire.pdf
File Size: 46 kb
File Type: pdf
Download File

covid-liability-waiver.pdf
File Size: 45 kb
File Type: pdf
Download File


Online Integrated Forms:

Location

4100 W ALAMEDA AVE, STE 102
BURBANK, CA 91505

818-841-1212

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Office Hours

Mon:  9:00 - 5:00
Tue:  9:00 - 5:00
Wed:  9:00 - 5:00
Thu:  9:00 - 5:00
Fri:  9:00 - 5:00

Closed for Lunch M-F 
1:00 to 2:00

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