• Skip to main content
  • Skip to site footer

11250 Pleasant Valley Rd
Penn Valley, CA 95946

Call: 530.432.2020

Donald J. Beilstein, O.D.
Mujahid A. Hines, M.D.

Wildwood Eyecare Center

Wildwood Eyecare Center
  • Home
  • Our Doctors
  • Our Staff
  • Eyecare Services
  • Fashion Eyewear
  • Lens Options
  • Patient Forms
  • Insurances
Vision Source

Patient Forms

Please return this completed form and our office will contact you as soon as possible to schedule your new patient appointment. Thank you!

New Patient Intake Form
Request for Medical Records

When you have completed the forms above you may scan them or take a picture of them with your phone and submit them using the file upload feature below.

Name(Required)
Max. file size: 300 MB.
This field is for validation purposes and should be left unchanged.

Office Hours

Monday: 8:30 – 5:00
Tuesday: 8:30 – 5:00
Wednesday: 8:30 – 5:00
Thursday: Closed
Friday: 8:30 – 5:00

Closed for Lunch: 1pm to 2pm

Contact Us

11250 Pleasant Valley Road
Penn Valley, California 95946

Phone: 530.432.2020
Fax: 530.432.7666

Email: 
WildwoodEyecareCenter@yahoo.com

Located across the street from the 
main gate of Lake Wildwood.

Location

Copyright © 2025 · Wildwood Eyecare Center · All Rights Reserved
Website by Digital Donkey Marketing

This site uses cookies to give you the best browsing experience—because who doesn’t love a good cookie? By staying here, you’re saying ‘yes’ to our cookies (the digital kind, sorry).Got it!