Burbank

1051 W Burbank Blvd

Burbank, CA 91506 United States

(818) 841-7055

Van Nuys

6100 Sepulveda Blvd

Van Nuys, CA 91411 2503 United States

(818) 373-0212

Online Forms

At Dr. Michael Khoury & Associates, 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 AdobeReader® 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 or bring them with you to your appointment.

New Patient Health History Form – Required

Please complete this form as it lets us know the history and current state of your health. Let us know what questions, concerns, and goals your have regarding your eye health or vision on the form.

Download & Print Form


Download the Free AdobeReader®

Contact Us

We look forward to hearing from you.

Location

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Hours of Operation

Our Regular Schedule

Hours Of Operation

Monday:

10:00 am-7:00 pm

Tuesday:

10:00 am-7:00 pm

Wednesday:

10:00 am-7:00 pm

Thursday:

10:00 am-7:00 pm

Friday:

10:00 am-7:00 pm

Saturday:

9:30 am-5:00 pm

Sunday:

10:00 am-5:00 pm