Patient
Forms
Save time at your appointment — download and complete these forms before you arrive.
Patient Paperwork
Complete Before Your Visit
To make your visit as efficient as possible, we encourage all new patients to download and complete the forms below before arriving. You may bring completed forms to your appointment or return them to our office in advance.
New Patient Registration
Your basic personal and demographic information. Please complete before your first visit.
For: New patients
Download PDFMedical & Ocular History
Your current and past health history, medications, and any previous eye problems.
For: New patients (or patients with changes to medical history)
Download PDFVision Insurance Verification
Help us verify your vision insurance benefits before your appointment.
For: All patients using vision insurance
View Insurance InfoContact Lens Consent Form
Required acknowledgment of proper contact lens wear and care procedures.
For: Patients requesting contact lens fittings
Download PDFHIPAA Privacy Notice Acknowledgment
Acknowledges receipt of our privacy practices notice.
For: All new patients
View NoticePre-Operative Questionnaire
Required for patients scheduled for eye surgery co-management evaluations.
For: Surgical patients
Download PDFNeed assistance? If you have trouble downloading any form, please call our office at (817) 453-4682 and we will be happy to mail or fax them to you. Forms are also available at our front desk when you arrive.
Insurance
Insurance We Accept
We accept most major vision and medical insurance plans. Please call our office to verify your specific coverage before your appointment.
Vision Insurance Plans
Important Notes
- Insurance questions? Call us at (817) 453-4682
- Please bring your insurance card to every visit
- We bill your insurance as a courtesy
- You are responsible for any co-pays, deductibles, or non-covered services
- We are happy to provide itemized receipts for out-of-network reimbursement