Online Forms

At Brecheen Learning and Vision Center, 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 AdobeReaderĀ® to download and complete the forms. Click here to download.
  • 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.

Adult New Patient Form

Download & Print Form

Child New Patient Form

Download & Print Form


Lifestyle Checklist for Extended Non-Routine Visual Evaluations

Please fill out this form only if not coming in for a regular eye exam, but for an Eye Trac or an Orthoptics evaluation.

Download & Print Form


Download the Free AdobeReaderĀ®

Hours of Operation

Office Hours

Monday

9:00 am - 5:00 pm

Tuesday

9:00 am - 5:00 pm

Wednesday

9:00 am - 5:00 pm

Thursday

9:00 am - 5:00 pm

Friday

9:00 am - 5:00 pm

Saturday

By Appt.

By Appt.

Sunday

Closed

Los Angeles Office

Monday

9:00 am - 5:00 pm

Tuesday

9:00 am - 5:00 pm

Wednesday

9:00 am - 5:00 pm

Thursday

9:00 am - 5:00 pm

Friday

9:00 am - 5:00 pm

Saturday

Closed

Sunday

Closed

Office Hours

Monday
9:00 am - 5:00 pm
Tuesday
9:00 am - 5:00 pm
Wednesday
9:00 am - 5:00 pm
Thursday
9:00 am - 5:00 pm
Friday
9:00 am - 5:00 pm
Saturday
By Appt. By Appt.
Sunday
Closed

Los Angeles Office

Monday
9:00 am - 5:00 pm
Tuesday
9:00 am - 5:00 pm
Wednesday
9:00 am - 5:00 pm
Thursday
9:00 am - 5:00 pm
Friday
9:00 am - 5:00 pm
Saturday
Closed
Sunday
Closed

Location

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