Dear Terry & Kim Eye Institute Patient:

Welcome to the Terry & Kim Eye Institute! Thank you for allowing us the opportunity to serve your eye care needs. We value all of our patients and are committed to providing you with compassionate and advanced eye care services.

Please take a few moments prior to your appointment to review and complete the registration forms. We ask you that you bring the completed forms to your appointment along with your insurance card.

Please arrive 10 minutes early to your appointment. We appreciate your assistance.

Please click on the tabs below to download the forms that will need to be completed in order for us to assist with your care.

Patient Registration Form

HMO ABN Form

Patient Medical History - English

Patient Financial Responsibility

PPO ABN Form

Patient Medical History - Korean

HIPPA Form

Medicare ABN Form

Patient Medical History - Spanish

Contact Lens Consent & Agreement

Terry & Kim Eye Institute Patient Portal Access

With Terry & Kim Eye Institute Patient Portal, you can connect with your doctors through secure intramail and update your medication, pharmacy, and demographics informations. Please click on the tab below to enter your Patient Portal. If you don't have your User ID and Password for Patient Portal, please ask the front desk receptionists for more information.

Terry & Kim Eye Institute Patient Portal

Dear Terry & Kim Eye Institute Patient:

Welcome to the Terry & Kim Eye Institute! Thank you for allowing us the opportunity to serve your eye care needs. We value all of our patients and are committed to providing you with compassionate and advanced eye care services.

Please take a few moments prior to your appointment to review and complete the registration forms. We ask you that you bring the completed forms to your appointment along with your insurance card.

Please arrive 10 minutes early to your appointment. We appreciate your assistance.

Please click on the tabs below to download the forms that will need to be completed in order for us to assist with your care.

Terry & Kim Eye Institute Patient Portal Access

Call and schedule an eye consultation today!

714-525-2375

Dear Terry & Kim Eye Institute Patient:

​

Welcome to the Terry & Kim Eye Institute! Thank you for allowing us the opportunity to serve your eye care needs. We value all of our patients and are committed to providing you with compassionate and advanced eye care services.

​​

Please take a few moments prior to your appointment to review and complete the registration forms. We ask you that you bring the completed forms to your appointment along with your insurance card.

​

Please arrive 10 minutes early to your appointment. We appreciate your assistance.

​

Please click on the tabs below to download the forms that will need to be completed in order for us to assist with your care.

Terry & Kim Eye Institute Patient Portal Access