Forms

Dear Patient:

Thank you for choosing Eye Physicians of Austin for your vision care and eye health.

Please print and complete the registration forms below and bring them with you to your scheduled appointment. Do not mail these forms to our office prior to your visit.

You must bring your insurance card(s) to your office visit. If your insurance policy has an office visit co-pay, please bring your co-pay with you. We accept cash, checks and all major credit cards.

If you have an insurance plan such as an HMO that requires a referral number, please verify with our office that the referral number has been received prior to your visit.

If you wear glasses or contact lenses please be sure to bring them with you for your office visit.

Please bring a list of any medications you are taking.

Thank you for your cooperation; we look forward to serving you.

Sincerely,
Eye Physicians of Austin, P.A.

Patient Information Form

Financial Policy Form

Records Release Form*

Consent to Treat Minors Form

* NOTE: The Records Release form is only necessary if you are requesting a copy of your records.

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