Patient Forms


Patient History Questionnaire

In order to make your experience with us as easy as possible, please fill out this questionnaire completely before you arrive. Have a great day!

If you are a new patient with us please bring your current prescription eyeglasses, contact lenses boxes etc, to your scheduled appointment.

Retinal Photo Consent Form
As part of your eye exam, we at Eye Appeal Optometry recommend a special diagnostic procedure called RETINAL PHOTOS. This procedure consists of taking a photograph of the back part (retina) of your eye, and is suggested for both adults and children.

Eye Appeal Optometry
31843 Rancho California Road, Suite 100
Temecula, CA 92591
Phone: 951-289-5044
Fax: 951-587-6550
Office Hours

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