HARRY W. CHAN, OD & JAMIE M. WONG, OD
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Patient Forms

Access our patient forms that you can fill out before your next visit to our office.
Patient Registration & History Form
File Size: 146 kb
File Type: pdf
Download File

Acknowledgement of Notice of Privacy Practices
File Size: 46 kb
File Type: pdf
Download File

Authorization for Release of Health Infomation
File Size: 50 kb
File Type: pdf
Download File

Contact Us
Harry W. Chan, OD
1895 Mowry Ave, Suite 117
Fremont, CA 94538
Phone: 510-797-8770

​Email: drchansstaff@yahoo.com
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Office Hours
Mon    9:00 am - 5:30 pm
Tue     9:00 am - 5:30 pm
Wed    9:00 am - 5:30 pm
Thu     11:00 am - 7:30 pm
Fri       9:00 am - 4:00 pm
​Sat      By Appointment Only

  • Home
  • Privacy Notice
  • FAQ
  • Contact us
  • Patient Forms
  • Eye Care Articles