David W Chia, M.D. FACS & Li-Li S Chia, M.D. Eye Physicians and Surgeons

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Office Forms
In order to serve you better and to save time at your visit, we have made our practice forms available for you.  You may print out the two forms and bring them to your visit.
 
Patient Registration Forms (please fill out both below!)

 
Health History PDF Form - online fillable
Physician Referral Forms

 
Note: These forms require the free Adobe Acrobat reader.
 
You may fill out these forms online in your web browser to print them at home.
 
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