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Patient Forms

NEW PATIENT FORMS
File Size:	301 kb
File Type:	pdf

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Notice of Privacy Practices (HIPAA)
File Size:	42 kb
File Type:	pdf

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EXISTING PATIENT FORMS
File Size:	260 kb
File Type:	pdf

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AMD Risk (for Patients Ages 50+)
File Size:	387 kb
File Type:	pdf

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You can securely upload the completed forms to us or please print and bring them with you to your appointment.
*Don't forget to download and save the PDF before submitting otherwise the forms will be sent to us blank.

Submit Completed Forms Here

​Any child under 18 that is not being accompanied by their parent or legal guardian, please fill out the Non-Parent Consent Form if someone else will be bringing them to the appointment.

Non-Parent Consent Form.pdf
File Size:	35 kb
File Type:	pdf

Download File

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Appointment Request

IMPORTANT
You will receive an e-mail once your appointment is received and confirmed.  Please call or text us at (281) 465-8300 if you do not receive a confirmation e-mail within 2 hours of your request during business hours.

Vision Plans Accepted

• VSP
• EyeMed
• Humana Vision
• Spectera

Medical Plans Accepted

• Aetna
• BlueCross BlueShield
• Cigna
• UnitedHealthcare
• Medicare

If you do not see your plan listed here, please give us a call and we would be happy to assist you. Our staff is also always available to answer any questions regarding your benefits.