Forms

New Patients

Please download and complete the following forms prior to your visit:
New Patient Packet Medical History

Patients and Physicians

If you would like to refer someone to our practice, please fill out the appropriate form and THANK YOU in advance:
Sunnyvale Referral Gilroy Referral

Retinal Disease Q&A

If you are suffering from retinal disease, or think you may have this eye emergency, time is of the essence. Learn more about what to do if you have a retinal disease.
Amsler Grid

Amsler Grid Test – Between eye exams, you can monitor your vision using a tool called an Amsler Grid. While focusing at the dot in the center, you may notice that the straight lines in the pattern appear wavy to you, or you may notice some lines are missing. Looking at an Amsler Grid on a daily basis will help you stay alert to any sudden changes in your vision.

To Use:
  1. If you wear glasses or contacts, make sure you are wearing them before you take the test.
  2. Position chart 14 inches away from your face (click HERE for printable version)
  3. Cover one eye with your hand.
  4. Focus on the dot in the center.
  5. Call our office if there is any change from your baseline the first time you took the test.
To apply to work at South Bay Retina, please complete the following application:
Application South Bay Retina

OUR LOCATIONS

Choose your preferred location
 
Sunnyvale

333 El Camino Real, Suite 340, Sunnyvale, CA 94087

 
Gilroy

39360 No Name Uno, Suite 210, Gilroy, CA 95020