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OFFICE FORMS

Copyright © 2011 FERNANDO CHEN, OD, INC All Rights Reserved | Privacy Policy

Located Inside Costco® 1445 R ST, MERCED, CA 95340 P: 209.726.8116


If you need to cancel or reschedule your appointment kindly give us 24 hours notice.

Downloadable Forms

For your convenience, you can download and fill out forms prior to your scheduled appointment.

Please click on the forms below to download them to your computer.

Print out your forms and fill them out in its entirety. And don't forget to bring them to our office for your appointment.

Please print legibly.

Please bring in any current or old glasses or contact lens prescriptions to your appointment also.

Patient History Form (Spanish)

Patient History Form (English)