Fremont Vision Source Online Forms

At Fremont Vision Source, we offer patient forms online so you can complete them in the convenience of your own home or office. Fax or email us your completed forms or bring them with you to your visit.
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  • If you do not already have AdobeReader® installed on your computer, Click Here to download it now.

  • Download the necessary form(s) and fill in the required information.

  • Fax or email us your completed form(s) or bring them with you to your appointment.

Welcome to Our Office Form - English
Download
Welcome to Our Office Form - Spanish
Download
Notice of Privacy Practices - English
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Notice of Privacy Practices - Spanish
Download
Acknowledgement of Notice of Privacy Practices - English
Download
Acknowledgement of Notice of Privacy Practices - Spanish
Download
Non-Discrimination Policy - English
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Non-Discrimination Policy - Spanish
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Limited English Proficiency Policy - English
Download
Limited English Proficiency Policy - Spanish
Download
No Surprises Act – Good Faith Estimates
Download
Appointment Background Image