Avant Optometry
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Patient  forms


  • ​​2-Page Welcome Form 
  • ​HIPAA Privacy Policy Receipt
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Please read our ​​Notice of Privacy Practices.  In summary, we will protect and keep confidential all of your personal information, such as your social security number and date of birth.  If you are a ​NEW patient, fill out ​the 2-Page Welcome Form and sign the HIPAA Privacy Policy Receipt ​and then email both forms back to us prior to your appointment; completing and sending in this paperwork beforehand will expedite your check-in time on the day of your visit.


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Picture
Your eyes are a window to your health and wellness!  We recommend both Pupil Dilation and Retinal Imaging as essential parts of a comprehensive eye exam.  Retinal Imaging (optomap®) captures a high-resolution digital scan of the macula, retina, optic nerve, and blood vessels for the early detection of eye diseases (macular degeneration, retinal detachment, glaucoma, melanoma) as well as general health problems (high blood pressure, diabetes, stroke, cancer).  The optomap® does NOT replace Pupil Dilation (the standard technique used to examine the health of the eyes) but is complementary to it and is an excellent alternative if dilation is not convenient for you at the time of your visit.  Early disease detection is vital to preserving a healthy eye and body; we strongly recommend Retinal Imaging for every patient. Since the optomap® is typically not covered by vision insurance, our fee for this optional diagnostic test is $39.00. 
Contact Information
811 Santa Cruz Avenue
Menlo Park, CA 94025
Phone: 650-326-2177
FAX: 650-326-8154
E-mail: ​see2020@avantoptometry.com
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Office Hours
Monday          9:00 am - 5:00 pm
Tuesday          9:00 am - 5:00 pm
Wednesday  9:00 am - 5:00 pm
Thursday        9:00 am - 5:00 pm
Friday               9:00 am - 5:00 pm
Saturday                   Closed
Sunday                       Closed
Notice of Privacy Practices
Website by Eyefinity

  • Home
  • Our Practice
    • Services
  • Location
  • Patient Forms
  • New Frames
  • New Contact Lenses
  • Promotions
  • Privacy Notice
  • Eye Care Articles