Vision Optix Optometry (BrentwoodAntioch offices)
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Patient Forms


    Fill out your forms online to save time at check in!  Click below!

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Click here to fill out your patient information form online.  A separate form submission should be made for each individual patient. Or you can print the documents below, fill them out, and bring them with you to your appointment.  

     Or print hard copies of your forms and complete them before your visit.  Click below!

Please print and complete our patient info/medical history form.
Medical History Form
File Size: 120 kb
File Type: pdf
Download File

Please print and sign acknowledging that you have read our Notice of Privacy Practices.
Acknowledgement of Privacy Practices
File Size: 81 kb
File Type: pdf
Download File

Please read our Notice of Privacy Practices.  You may keep this document for your reference. 
Notice of Privacy Practices
File Size: 88 kb
File Type: pdf
Download File


Contact Us
​Balfour Vision Optix Optometry

3840 Balfour Rd. Suite A
Brentwood, CA 94513
925-513-0323
​

Office Hours
Mon    9:00 am - 6:00 pm 
Tue     9:00 am - 6:00 pm
Wed    9:00 am - 6:00 pm
Thu     9:00 am - 6:00 pm 
Fri       9:00 am - 6:00 pm
​Sat & Sun Closed
​(Closed 1:00-2:00 pm daily for lunch)
Contact us
Family Optometric Vision Care

5109 Lone Tree Way
Antioch, CA 94531
​​925-757-5560
925-778-1505

Notice of Privacy Practices
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  • Home
  • Our Doctors
  • Our Services
  • Hours & Locations
  • Patient Forms
  • Eye Care Articles
  • FSA Benefits
  • Promotions