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BOOK AN APPOINTMENT
CALL US 310-944-9393
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  • Home
  • About RMI
    • Our Doctors
      • Ron P. Gallemore, M.D., Ph.D.
      • Michael Heeg, M.D.
      • Lindsay Grotting, M.D.
      • Josh Wallsh, M.D.
      • Masumi Asahi, D.O.
    • Our History
    • Our Staff
  • For Patients
    • Your First Visit
    • Eye Conditions
      • Branch Retinal Artery Occlusion
      • Central Serous Choroidopathy
      • Cytomegalovirus (CMV) Retinitis
      • Diabetic Retinopathy
      • Dislocated IOL
      • Endophthalmitis
      • Macular Degeneration
      • Macular Hole
      • Macular Pucker
      • Ocular Trauma
      • Ocular Tumors
      • Retinal Artery Occlusions
      • Retinal Tear and Detachment
      • Retinal Vein Occlusion
      • Retinitis Pigmentosa and other Retinal Degenerations
      • Uveitis
    • Patient Testimonials
    • Patient Instructions
      • Retinal Surgery
      • Injections
      • Cryotherapy
      • Laser
      • Face Down Device
    • Patient Forms
  • Treatments
    • Intravitreal Injections
    • Laser
    • Photodynamic Therapy
    • Combination Therapy
    • Pneumatic Retinopexy
    • Cryotherapy
    • Implants
    • Retina Surgery
    • Photobiomodulation Therapy
  • Technology
    • Fluorescein Angiography
    • Color and Red-Free Photography
    • Optical Coherence Tomography
    • Heidelberg SPECTRALIS + OCT
    • Ocular Ultrasound
    • Electrophysiology Testing
  • Clinical Trials
  • Referring Doctors
  • Locations
    • Downtown LA
    • South Bay
RMI Logo
  • Home
  • About RMI
    • Our Doctors
      • Ron P. Gallemore, M.D., Ph.D.
      • Michael Heeg, M.D.
      • Lindsay Grotting, M.D.
      • Josh Wallsh, M.D.
      • Masumi Asahi, D.O.
    • Our History
    • Our Staff
  • For Patients
    • Your First Visit
    • Eye Conditions
      • Branch Retinal Artery Occlusion
      • Central Serous Choroidopathy
      • Cytomegalovirus (CMV) Retinitis
      • Diabetic Retinopathy
      • Dislocated IOL
      • Endophthalmitis
      • Macular Degeneration
      • Macular Hole
      • Macular Pucker
      • Ocular Trauma
      • Ocular Tumors
      • Retinal Artery Occlusions
      • Retinal Tear and Detachment
      • Retinal Vein Occlusion
      • Retinitis Pigmentosa and other Retinal Degenerations
      • Uveitis
    • Patient Testimonials
    • Patient Instructions
      • Retinal Surgery
      • Injections
      • Cryotherapy
      • Laser
      • Face Down Device
    • Patient Forms
  • Treatments
    • Intravitreal Injections
    • Laser
    • Photodynamic Therapy
    • Combination Therapy
    • Pneumatic Retinopexy
    • Cryotherapy
    • Implants
    • Retina Surgery
    • Photobiomodulation Therapy
  • Technology
    • Fluorescein Angiography
    • Color and Red-Free Photography
    • Optical Coherence Tomography
    • Heidelberg SPECTRALIS + OCT
    • Ocular Ultrasound
    • Electrophysiology Testing
  • Clinical Trials
  • Referring Doctors
  • Locations
    • Downtown LA
    • South Bay
BOOK AN APPOINTMENT
CALL US 310-944-9393

Patient Forms

New Patient Forms (English)

Formularios Para Pacientes Nuevos (Español)

Medical Records Authorization Form (Patient Request)

Medical Records Authorization Form (Patient Request) — Large Print

BOOK AN APPOINTMENT

Locations

SOUTH BAY
4201 Torrance Blvd
Suite 220
Torrance, CA 90503
Phone: 310-944-9393

DOWNTOWN LA
1414 S. Grand Ave.
Suite 105
Los Angeles, CA 90015
Phone:  310-944-9393

Patient Information

Our Doctors
Patient Instructions
Patient Forms
Your First Visit
Eye Conditions

Legal

  • Notice of Privacy Practices (English)
  • Notice of Privacy Practices (Spanish)
  • Legal Liability Disclaimer (Terms Of Use)
  • Nondiscrimination and Accessibility Notice (English)
  • Nondiscrimination and Accessibility Notice (Spanish)
  • Good Faith Estimate (English)
  • Good Faith Estimate (Spanish)
  • Privacy Notice
  • CCPA Notice
  • CA Open Payments

Retina Macula Institute, an Affiliate of PRISM Vision Group
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