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Call Us Today

(714) 529-2470
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Make an Appointment

                                                         

At Customized Vision Care, we value your time. In an effort to save you time at our office, you can complete the patient registration and health history information online prior to your appointment by downloading the forms below.

Please note there is a 24-hour cancellation policy. There will be a $25.00 cancellation fee for all missed appointments.


                                                   Patient Registration Form


After printing and completing the forms, you can submit it to us through the following 3 options…

  1. Bring the forms with you at the time of your appointment
  2. Email to patients@kirschen.net
  3. Fax to (866) 801-4739

Also, when you come into the office, please.... 

-Wear your contact lenses (if applicable) 

-Bring glasses 

-Bring in any previous eye medical records, glasses prescriptions, and/or contact lens prescriptions (manufacturer and brand). 

If you have any questions, feel free to contact us at (714) 529-2470 anytime.

Thank you and we look forward to seeing you soon!

Services
We strive to provide complete care for our patients. Learn more about all the services we provide.
Make An Appointment
We will do our best to accommodate your busy schedule. Schedule an appointment today!
Online Forms
Our patient forms are available online so they can be completed in the convenience of your own home or office.