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Patient Resources

Exciting Update: Online Bill Pay Now Available!

Great news! We’ve partnered with InstaMed to simplify your medical billing experience. Create an InstaMed Account and simplify the way you manage and pay your healthcare bills for all of your providers and family members. Get started at the link below:

Online Bill Pay

For Your Visit!

Pacific Eye Institute Front Desk

The team at Pacific Eye Institute is dedicated to making your experience with us an exceptional one. For your convenience, we’ve made our patient forms available online to help make your visit easy and convenient. Prior to your visit, please print, complete and sign the appropriate forms, and give them to our staff upon your arrival.

In addition to the forms below please be sure to bring:

Prior to your visit at Pacific Eye Institute, we ask that you complete the online patient registration via the link below. Patients may also complete additional paperwork prior to their visit by visiting the patient forms section on this page.

Pacific Eye Institute Online Patient Registration

All Patients

COVID-19 Medical Care Consent
New Patient Packet – English
New Patient Packet – Spanish
Notice of Privacy Practice
Notice of Non-Discrimination
Language Assistance
Medication Refill Policy

Surgical Patients

Pre-operative Instructions
Post-operative Instructions

Alphaeon Credit Card for better vision

There’s an easier way to pay for your vision care! We’re pleased to accept the Alphaeon Credit card, designed exclusively for your health and wellness needs. With Alphaeon Credit, you can move forward with your procedure right away and pay over time with flexible monthly payments that fit your budget. Whether you’re considering LASIK, cataract surgery, or need new glasses or contacts, Alphaeon Credit makes it simple to invest in your eye health without financial stress. See clearer, sooner!

Your healthcare credit card

Alphaeon Credit is a credit card designed exclusively for health and wellness services, including vision care. With Alphaeon Credit, you can enjoy special financing on purchases of $250 or more* for procedures not typically covered by insurance, such as LASIK and Premium IOLs. Don’t wait to improve your vision—get the care you need today and pay over time!

Learn more about Alphaeon

We are continually working to add new accepted insurance plans to our network. We have added several new providers in 2025. Please view our insurance list below and if you have questions please feel free to contact us!

Insurance List – As of February 2025

To request your medical records, please click on the button and follow the steps:

Record Request

Locations

Serving Our Community

Pacific Eye Institute is a top-rated ophthalmology practice providing comprehensive medical and surgical eye care as well as routine and preventive ophthalmology services to our patients in the Inland Empire.

All Locations
Apple Valley
Apple Valley – High Desert Eye Surgery Center
Colton
Eastvale
Inland Eye LASIK (Rancho Cucamonga)
Rancho Cucamonga
Temecula
Upland
All Locations

Apple Valley

15099 Kamana Rd.
Apple Valley, CA 92307
Additional Apple Valley Information

Apple Valley – High Desert Eye Surgery Center

High Desert Eye Surgery Center
16030 Kamana Road
Apple Valley, CA 92307
Additional Apple Valley – High Desert Eye Surgery Center Information

Colton

1900 E Washington St,
Colton, CA 92324
Additional Colton Information

Eastvale

12442 Limonite Ave., Suite 200
Eastvale, CA 91752
Additional Eastvale Information

Inland Eye LASIK (Rancho Cucamonga)

Inland Eye LASIK
9481 Haven Ave., Suite 200
Rancho Cucamonga, CA 91730

  • LASIK Center:

    909-937-9230
    We accept calls until 7 p.m. on weekdays or weekends 9AM -3PM
Additional Inland Eye LASIK (Rancho Cucamonga) Information

Rancho Cucamonga

8112 Milliken Ave., Suite 203
Rancho Cucamonga, CA 91730
Additional Rancho Cucamonga Information

Temecula

41877 Enterprise Circle N., Suite 110
Temecula, CA 92590
Additional Temecula Information

Upland

555-591 North 13th Ave.
Upland, CA 91786

** Our Retina and Oculoplastic Clinics are located at 591 North 13th Avenue.
Additional Upland Information
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