Logo James K. Kurata, O.D.
Jennifer M. Chin, O.D.
OPTOMETRIST
200 S. San Pedro Street
Suite B
Los Angeles, Ca 90012 | Map Us!
Tel: (213) 617-2020
Fax: (213) 617-3184

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Monday   9:00 - 1:00
Monday   9:00 - 5:00
Tuesday   9:00 - 6:00
Wednesday   9:00 - 5:00
Thursday   9:00 - 6:00
Friday   9:00 - 5:00
Saturday   9:00 - 5:00

To expedite your appointment, please feel free to download and print the office forms listed below and bring the completed forms to your appointment.

Additionally you may download the files individually if that is your preferred method.

Demographics Form
Notice of Privacy Practices
Medical History Questionnaire
Receipt of Notice of Privacy Policies & Consent Form
Retinal Photos & Dilation

It's true in some cases the file may not download directly to your computer depending on your browser settings. To save the file to your computer when it opens in a new window right click with your mouse and save the file to your preferred location.


Kurata Eyecare Center 200 South San Pedro St. Suite B Los Angeles, CA 90012 Phone: (213) 617-2020 Fax: (213) 617-3184

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