Patient Forms
Downloadable patient forms that you can print and fill out before your next visit to Fremont Vision Source in Fremont.
For your convenience, we have created the following pages to provide you with a list of the insurance carriers we accept at our Fremont optometric office, as well several downloadable forms to save you time at your next appointment.
Downloadable Forms
- Welcome to Our Office Form [English] [PDF]
- Welcome to Our Office Form [Spanish] [PDF]
- Notice of Privacy Practices [PDF]
- Notice of Privacy Practices [Spanish] [PDF]
- Acknowledgement of Notice of Privacy Practices [PDF]
- Acknowledgement of Notice of Privacy Practices [Spanish] [PDF]
- Non-Discrimination Policy [English][PDF]
- Non-Discrimination Policy [Spanish] [PDF]
- Limited English Proficiency Policy [English][PDF]
- Limited English Proficiency Policy [Spanish] [PDF]
- No Surprises Act – Good Faith Estimates [English][PDF]