Patient Forms
In preparation for your visit, please complete the questionnaires online and send prior records to our office.
1. SETUP YOUR PATIENT PORTAL
You will receive an email invitation to create your very own patient portal. Please sign up ASAP and complete the online questionnaire, before the link expires. Through this portal you can: securely complete the necessary paperwork prior to your appointment, communicate with our office, access your health records, reports and statements. Prior records can also be uploaded through the portal for our review.
Learn more by video, watching the first 2 minutes: OnPatient Overview // EHR – Practice Management | drchrono
Learn more by written instructions: click here
Alternatively, you may also submit the forms by hand, following steps under “Submit Forms Manually”
As a new Patient, please arrive 15 MINUTES EARLY for Check in.
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2. REQUEST FOR RELEASE OF RECORDS
Request prior records that may be important for your visit using this form (ie: referring provider, last eye exam, or neuro evaluations) to be sent by fax.
Secure fax number for both locations: (510) 853-7047
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submit forms manually
We would like you to complete the intake forms electronically in the steps above, but the forms may also be completed by hand and sent to us or faxed ahead of time.
Secure fax number for both locations: (510) 853-7047
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Please fill out A, B, and ONE Questionnaire below
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Choose only ONE for Patient Questionnaire
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