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Patient Registration and Forms

You can prepare for your University Eye Center at Ketchum Health appointment in advance by completing the web registration or by printing and completing the necessary forms provided below. If you have any questions, please contact us at 323.234.9137 (phone) or 323.235.6203 (fax).

Patient Web Registration

Save time and paper by completing our online Patient Web Registration. 

Patient Web Registration

Patient Forms

English Version

Required for all patients

Specialty forms

Spanish Version

Formas para todos los pacientes

Formas para servicios especializados