New Patient Appointment Request

Thank you for contacting us. We would love to see you for an eye exam! 
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Please text us securely at 408-997-2020 the requested information below. This will allow us to create a patient profile for you. Then we will contact you to set up an appointment. 

1. Name of the primary insured with birthday and gender
2. Cell # for 1 day and 1 week appointment reminders. Please confirm your appointment by replying    "OK"    to the automated appointment reminder via text message
3. Address
4. Email(s) for primary insured and adult dependent(s) within the the same insurance plan
5. Type of insurance (VSP or Medicare PPO) AND an Insurance ID # if available
6. Name(s) of the patient(s) needing an eye exam with birthday(s) and gender
7. Your detailed availability (days of the week + time of the day ) - Dr. Yee sees patients on Monday and Tuesday. Dr. Hsieh sees patients from Wednesday to Friday. We will text you back a proposed appointment. Please reply to this proposed time and wait for us to confirm the appointment before coming to the office.

*You will get a secure email from our office to invite you to activate your Patient Portal. Please create your login within 72 hours and enter in your medical history information prior to your appointment on the secure portal (most preferred method).
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You can also visit our website to complete the Medical History Form at least 1 day prior to your appointment or bring the completed Medical History Form with you to the appointment.
https://www.almadeneyecare.net/patient-forms.html

Please use discretion when providing personal information via text message and email.

If you are unable to complete the medical history information before your appointment, please come 15 min. prior to your appointment time.

Thank you! We look forward to seeing you soon. 

Sincerely,
Almaden Family Optometric Center
6531 Crown Blvd. Suite 4
San Jose, CA 95120-2906
Phone/Text: (408) 997-2020
http://www.almadeneyecare.net