Chino Hills Eyecare Optometry
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Welcome Form
File Size: 524 kb
File Type: pdf
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Please fill out prior to your appointment.

Medical History Form
File Size: 56 kb
File Type: pdf
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Please fill out this medical history questionnaire prior to your appointment. All of your information is kept confidential.

Privacy Form
File Size: 478 kb
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We are a HIPAA compliant office. Please read and sign the following document prior to your appointment.

Dilation Authorization Form
File Size: 60 kb
File Type: pdf
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Contact Us
Dr. Suneet Gupta, O.D.
Chino Hills Eyecare Optometry
3233 Grand Ave. , Suite M
Chino Hills, CA 91709
Phone: 909-591-2034
Office Hours
Mon    9:00 am - 6:00 pm
Tue     9:00 am - 6:00 pm
Wed    10:00 am - 7:00 pm
Fri       9:00 am - 6:00 pm
Sat      By appointment only
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Notice of Privacy Practices
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  • Home
  • Our Practice
  • Location
  • Our Services
    • After Hours Care
  • Patient Forms
  • Bausch and Lomb
  • Eye Care Articles
  • Contact