DR .ANACLETO "NICK" GUTIÉRREZ, OPTOMETRIST
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patient forms

Patient Forms

Please take a moment to download and complete the above Patient History Form before your appointment.
 
Thank you!

Patient History Form - English
File Size: 350 kb
File Type: pdf
Download File

Patient History Form - Spanish
File Size: 357 kb
File Type: pdf
Download File

Hippa Acknowledgement Form
File Size: 355 kb
File Type: pdf
Download File

Dr. Anacleto "Nick" Gutiérrez O.D., MPH



​ADDRESS
2615 Capitol Avenue
Sacramento, California 95816


PHONE
916.447.2020

OFFICE HOURS
Monday - Friday
9 AM- 5PM
Saturday by appointment
8:30AM-12PM


We are ADA compliant.
Please e-mail us concerning  ADA compliance.

  • Home
  • ABOUT
  • Order Contacts
  • Schedule Appointment
  • Services
    • Promotions
    • Patient Forms
    • Eye Care Articles
  • Location