Skip to main content

Optometry: Forms

Patient History Questionnaire (PDF)woman in glasses

​To facilitate the check-in process, print the questionnaire, complete, and bring with you to your visit. This questionnaire is also available through SSO (single sign-on) upon check in at the clinic, or you can complete at home.

Authorization to Release Optometry Information (PDF)
If you would like your optometry records sent to another facility, download the authorization form and FAX to our office (858) 534-4749.

Make an Appointment

To make an appointment, call:
(858) 534-2602.

Contact Us

If you have questions, email us at:
SHS-Opto@ucsd.edu​