LOS GATOS EYE CARE
  • ABOUT US
    • OUR TEAM >
      • Team of Staff
      • Ilene Polhemus, OD
      • Maggie Enciso, OD
    • Insurance
    • Eye Education
  • Eye Exams
    • Adult Eye Exams
    • Pediatric Eye Exams
    • CONTACT LENSES
    • Emergency Visits
  • SPECIALTY EYE CARE
    • Dry Eye Therapy >
      • OptiLight (Intense Pulsed Light) >
        • OptiLight Blog
    • Myopia Management >
      • ​Orthokeratology​ >
        • ​Ortho-K for Adults
    • Lasik Co-Management
  • Eye Wear
  • Contact us
    • Hours & Location
    • Schedule an Appointment
    • Forms
    • Review us
  • Schedule an Appointment

Welcome ​to Los Gatos Eye Care!​


Below are our patient forms. You may choose to print and fill them out prior to your initial appointment. 
You will need Adobe Acrobat Reader to view these files.
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schedule an appointment online

What to bring to your exam:​ 

  • Current insurance cards/information
  • Current glasses
    • ​Primary glasses
    • Sunglasses / Sports glasses
    • Computer glasses
  • Contact Lens Patients:
    • Wear contact lenses to the appointment (Insert at least 2 hours prior)
      • DO NOT wear contact lenses if you are having SEVERE problems, but please bring them in your contact lens case
    • Contact Lens Prescription or boxes, labels, vials with specifications on it
    • Name of contact lens solutions

Financial Policy


Patient Financial Policy and Expectations
File Size: 77 kb
File Type: docx
Download File

Patient Financial Policy Signature
File Size: 70 kb
File Type: docx
Download File

Authorization To Retain Credit Card Information
File Size: 81 kb
File Type: doc
Download File

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Patient History Forms


patient_history_form__adult_2022.docx
File Size: 70 kb
File Type: docx
Download File

patient_history_form_pediatric_2022.docx
File Size: 43 kb
File Type: docx
Download File

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Records Release Authorization Form​


Records Release Authorization Form (to LGEC)
File Size: 83 kb
File Type: doc
Download File

Records Release Authorization Form (from LGEC)
File Size: 86 kb
File Type: doc
Download File

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We Would Love to Have You Visit Soon!


Hours

Mon-Thurs: 9am - 5pm
​Fri: 9am - 4pm
Saturday: CLOSED
(OPEN Saturdays: February 4th - 9AM - 1PM, February 18th  and February 25th 9 AM - 4PM)
Sunday: CLOSED

Telephone

408-377-2020

Email

eyes@lgeyecare.com
  • ABOUT US
    • OUR TEAM >
      • Team of Staff
      • Ilene Polhemus, OD
      • Maggie Enciso, OD
    • Insurance
    • Eye Education
  • Eye Exams
    • Adult Eye Exams
    • Pediatric Eye Exams
    • CONTACT LENSES
    • Emergency Visits
  • SPECIALTY EYE CARE
    • Dry Eye Therapy >
      • OptiLight (Intense Pulsed Light) >
        • OptiLight Blog
    • Myopia Management >
      • ​Orthokeratology​ >
        • ​Ortho-K for Adults
    • Lasik Co-Management
  • Eye Wear
  • Contact us
    • Hours & Location
    • Schedule an Appointment
    • Forms
    • Review us
  • Schedule an Appointment