W. SAM SHIELDS, O.D. & ASSOCIATES
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Patient Forms

New Patient Welcome Letter
File Size: 57 kb
File Type: pdf
Download File

As a new patient to our office, welcome and thank you for choosing us. We feel it is an honor to provide the best eye vision and health care for you!

Please review the New Patient Welcome Letter which is available by clicking on the form name above.
You will also be asked to review our Notice of Privacy Practices which is also available by clicking on the form name which is toward the bottom right side of this page.
Visit Us
W. Sam Shields, O.D. & Associates

2812 Cochran St
Simi Valley, CA 93065

Get In Touch
Phone: (805) 527-6164
Email: info@drwsamshields4eyes.com


Office Hours
Monday:  9:00 am - 5:30 pm

Tuesday:  10:00 am - 7:00 pm
Wednesday:  9:00 am - 5:30 pm
Thursday:  9:00 am - 5:30 pm
​Friday:  9:00 am - 5:30 pm
Saturday:  9:00 am - 1:00 pm
Notice of Privacy Practices
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  • Home
    • Location
    • Eye Care Articles
  • About Us
  • Services
    • Comprehensive Eye Exam >
      • Retinal Imaging
    • Contact Lens Exam & Fitting
    • Medical Eye Exams >
      • LASIK & ICL
  • Telemedicine
  • Insurance
    • New Patient Form
  • Eyewear
  • Order Contacts
  • Request Appointment