Patient Resources
Patient Forms
To reduce waiting time in our office, we encourage you to download and fill out our Patient Registration Forms. Please bring these forms with you to your appointment.
- Patient Demographic form in English
- Patient History form in English
- Patient Demographic form in Spanish
- Patient History form in Spanish
Please note you will need to bring both the Patient Demographic form and Patient History form with you to your appointment.
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f you are unable to open PDF files, you may need to download the free Adobe Acrobat Reader program. Adobe Reader software is the global standard for electronic document sharing. It is the only PDF file viewer that can open and interact with all PDF documents.
Vision Care Payment Options
At Pacific Eye, financial considerations should not be an obstacle in obtaining LASIK Eye Surgery. Our goal is to make LASIK Eye Surgery affordable for any budget. It is for this reason that we make Lasik affordable by offering a combination of expertise, experience and advanced technology at a price everyone can afford.
Choose any of the following payment options:
- Cash or Check
- Credit Card
- Monthly Payment Plan
Chase Health Advance
Pacific Eye is pleased to offer our patients affordable, vision care financing programs. Our Chase Health Advance Monthly Payment Plans offer the following:
- Zero Down Payment & Zero Interest for 12 Months
- Zero Down Payment & Low Monthly Payments with Fixed Interest Rate
- Zero Prepayment Penalty
To apply with Chase Health Advance, call their toll-free number, 888-519-6111. The application process is fast, easy and completely confidential 24 hours a day, 7 days a week. For a credit application, click here. Have our Merchant ID# 30071 ready!
Local Credit Union Financing
We are pleased to offer local, friendly, credit union financing through Lifestyle Lending Solutions. For decades, Credit Unions have been serving the local community with superior customer service and low interest rate financing. It only takes a few minutes to apply and get approved. Everyone, Everywhere can apply. So what are you waiting for?
Apply Now for local friendly Credit Union financing, its fast and easy!
Determine your estimated payment with our easy to use payment calculator.
