Please print the New Patient Form below and bring it with you to your appointment. 
Thank you. 
You may need to download Adobe Reader to view the .pdf file if your computer doesn't already have it.
Donald J. Beilstein, O.D.
Mujahid A. Hines, M.D.
11250 Pleasant Valley Road
Penn Valley California 95946
Phone: 530 . 432 . 2020