FREMONT OPTOMETRIC GROUP - Patient Forms
FREMONT OPTOMETRIC GROUP
Feel free to print out and complete this Welcome form before your visit for your convenience. Make sure to fill out your MEDICAL insurance information. If you need to come in for an eye emergency (ie. infection, inflammation, trauma, etc.) this visit mostly likely can only be billed to your medical insurance, not your vision insurance.
Feel free to print out and complete this Medical History form before your visit for your convenience. Please list ALL medications your are taking, not just ocular medications.

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Contact Us
39355 California Street
Suite 103
Fremont, CA 94538
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Across from Fremont Hub in the same plaza as Bank of America

Phone: 510-744-2010
Fax: 510-744-2015


Tue-Fri 8:45am - 6:00pm
Also Open ALTERNATE Mondays(8:45am-6:00pm)and Saturdays(8:00am-2:00pm) with Evening appointments available every other Wednesday. All visits by appointment only.


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