Chan Family Optometry

360 Sierra College Dr. Ste. 100

Grass Valley, CA 95945 US

(530) 273-3190

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All patients receive 20% OFF second pair of complete glasses!

Online Forms

New Patient Health History Form – Required

Please complete this form as it lets us know the history and current state of your health. Let us know what questions, concerns, and goals you have regarding your eye health or vision on the form.

Welcome Form


At Chan Family Optometry, 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.
  • Download the required form(s). Print out the form(s) and complete the required information.
  • Fax your printed and completed form(s) to our office or bring them with you to your appointment.

Download the Free AdobeReader®