ALOHA FAMILY OPTOMETRY
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Patient  Forms

patient_registration_new_2021-09.pdf
File Size: 176 kb
File Type: pdf
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Aloha!  Thank you for scheduling your appointment with us.  We look forward to seeing you soon!  We ask that you please complete and return your registration form to our office by email to support@alohafamilyoptometry.com prior to your appointment time. 

​The forms may be completed directly through your mobile phone or computer using AdobeReader.
​Here are the links below to download the app if needed


PC: You will need AdobeReader® to download and complete the forms. Click here to Download the Free AdobeReader®

Iphone/Applestore:  https://apps.apple.com/us/app/adobe-acrobat-reader-for-docs/id469337564
Andriod/Google Play Store: https://play.google.com/store/apps/details?id=com.adobe.reader

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Due to COVID-19 our office is taking every precaution possible to make Aloha Family Optometry a safe and comfortable place for our patients.  Our doors have reopened.  We continue to follow CDC guidelines for mask requirements and encourage everyone to practice safe social distancing.   Let us know If you have any questions or concerns.

We ask for 24 hour notice to avoid a cancellation fee should you need to reschedule your appointment to another time.  We'd be happy to help you reschedule by phone, text, email or in person.   Mahalo for your assistance and understanding! 
Aloha Family Optometry
1874 N. Placentia Avenue
Placentia, CA 92870
714-996-EYES(3937)
Office Hours
Tue      9am - 1pm, 2pm - 5:30pm
Wed     9am - 1pm, 2pm - 5:30pm
Thu     10am - 1pm, 2pm - 5:30pm
Fri        9am - 1pm, 2pm - 5:30pm
Sat       9am - 1pm

Holiday Hours updated on Google
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  • Home
  • REQUEST AN APPOINTMENT
  • Patient Forms
  • About
  • Aloha Team
  • Testimonials
  • Products
  • Services
    • Eye Care Articles
  • Insurance
  • Anniversary Fundraiser
  • Location