Online Forms

What To Expect On Your First Visit

Please note that on your initial visit to our office, you will have a dilated comprehensive examination. If necessary, further diagnostic testing may be required.

Please allow a least one and a half hours depending on the necessary testing required. Since the visit will include dilation, you should arrange transportation prior to visit since your vision will be blurred for several hours after your visit.

Please bring your identification card, current insurance information, a list of current medications and prior medical records if necessary.

New patient forms are available below to be filled out prior to your visit.

Online Forms

At Kent W. Small, MD Macula and Retina Institute, we value your time. In an effort to save you time in our office, you can download and complete our patient form(s) prior to your appointment.

  • You will need AdobeReader® to download and complete the forms. Click here to download.
  • Fax your printed and completed form(s) to our office at 818-552-5044/310-659-2822 or bring them with you to your appointment.

New Patient Registration Packet Form

Download & Print Form


Download the Free AdobeReader®

SIGN UP OR CALL 818-552-5040/310-659-2200 TO MAKE AN APPOINTMENT.

Location

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Hours of Operaton

Our Regular Schedule

Glendale

Monday:

8:00 am-5:00 pm

Tuesday:

8:00 am-5:00 pm

Wednesday:

8:00 am-5:00 pm

Thursday:

8:00 am-5:00 pm

Friday:

8:00 am-5:00 pm

Saturday:

Closed

Sunday:

Closed

Angeles

Monday:

8:00 am-5:00 pm

Tuesday:

8:00 am-5:00 pm

Wednesday:

8:00 am-5:00 pm

Thursday:

8:00 am-5:00 pm

Friday:

8:00 am-5:00 pm

Saturday:

Closed

Sunday:

Closed