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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