Patient Forms

Before your next appointment, please fill out the necessary forms. If you do not already have an appointment with us, you can request one here.

New Patient Form

New patients can either print their form and fill it out by hand to bring to their appointment or fill out the PDF and email it to us at

Returning Patient Form

We kindly ask that all returning patients make sure their file is up to date before their next appointment by filling out this printing this form and filling it out by hand to bring to their appointment or filling out the PDF and emailing it to us at


Vision Plans

La Paz Optometric Center is pleased to accept the following third-party vision plans:

  • Retail Clerks Union (Food and Drug)
  • Vision Service Plan (VSP)
  • Bristol Park Medical
  • Greater Newport Physicians (Hoag Hospital)
  • Eye Care Plan of America/(EMED)
  • Cole Vision/Vision One
  • Davis Vision
  • Medical Eye Services (MES)
  • SafeGuard
  • N.V.A./Heritage Optical
  • Group Vision Associates (GVA)
  • Aetna
  • Superior Vision
  • Blue Cross and Blue Shield
  • Healthnet
  • Unicare
  • Avesis
  • United Health Care (UHC)
  • Vision Benefits of America
  • Signature Vision Plan
  • EBA & M
  • Cigna
  • Physicians Care
  • Healthcomp
  • Medicare

If you have any questions about which vision plans we accept please contact our office for more information.