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Online Forms

At Kent W. Small, MD Macula and Retina Institute, 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 at 818-552-5044/310-659-2822 or bring them with you to your appointment.

New Patient Registration Packet Form

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SIGN UP OR CALL 818-552-5040/310-659-2200 TO MAKE AN APPOINTMENT.

Location

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Hours of Operaton

Our Regular Schedule

Glendale

Monday:

8:00 am-5:00 pm

Tuesday:

8:00 am-5:00 pm

Wednesday:

8:00 am-5:00 pm

Thursday:

8:00 am-5:00 pm

Friday:

8:00 am-5:00 pm

Saturday:

Closed

Sunday:

Closed

Angeles

Monday:

8:00 am-5:00 pm

Tuesday:

8:00 am-5:00 pm

Wednesday:

8:00 am-5:00 pm

Thursday:

8:00 am-5:00 pm

Friday:

8:00 am-5:00 pm

Saturday:

Closed

Sunday:

Closed