Almaden Family Optometric Center
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Patient  Forms

Please complete the Medical History Form and bring it with you to your eye exam. This will help our doctors to get to know you better. You can download the Medical History Form by clicking on the underlined link below 
Medical History Form
File Size: 705 kb
File Type: pdf
Download File

Notice of Privacy Practices
File Size: 244 kb
File Type: pdf
Download File


Dear Patients:

The Notice of Privacy Practices describes how your medical information may be used and disclosed, and how you can obtain access to this information. Please review it carefully.

We respect our legal obligation to keep health information, that identifies you, private. The law obligates us to give you notice of our privacy practices.

As a patient, you have the right to adequate notice of the uses and disclosures of your protected health information. Under the Health Insurance Portability and Accessibility Act (HIPAA), Almaden Family Optometric Center can use your protected health information for treatment, payment and healthcare operations.


For further information, please open the attached document by clicking on the underlined link above, and/or contact Drs. Linda Yee, Curtis W. Keswick or Dr. Jennifer Hsieh, O.D.

-Your Friendly Optometrists and Staff at
 Almaden Family Optometric Center
Contact Us
Almaden Family Optometric Center
6531 Crown Blvd, Suite #4
San Jose, CA 95120
Phone: 408-997-2020

Office Hours
Mon    9:15 am - 5:15 pm
Tue     9:15 am - 6:00 pm
Wed    9:15 am - 5:30 pm
Thu     9:15 am - 5:30 pm
Fri       9:15 am - 5:15 pm

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Notice of Privacy Practices
Website by Eyefinity
  • Home
  • Our Practice
    • Patients like us!
    • Special Events
    • Promotions
    • San Jose Chinese School
  • Our Services
    • Frames
    • Contact Lenses
    • Sunglasses
    • Corneal Topography
    • Fundus Photo Camera
    • Eye Care Articles
  • Patient Forms
  • Location