Eye Care Patient Forms
The Eye Clinic of Austin uses a specialized practice management software program. We ask every patient to participate in maintaining the following:
- Reviewing registration information
- Providing current insurance cards (required at every visit)
- Providing drivers license or state issued identification (required at every visit)
- Allowing us to capture your photo for your account and chart (so the doctor can identify your electronic medical record)
Patients are encouraged to print and complete the registration forms prior to arrival at our office. Simply click the link and the PDF download should begin. Be sure to bring your insurance card and identification with you.
A new patient is one who has not received any professional services from Eye Clinic of Austin within the past three years.
Patient Registration – English
Patient Registration – Spanish Patient Authorization Form
Authorization for Use or Disclosure of Medical Record Information
If you cannot provide proof of insurance on the day of your visit we will require you to read and agree by signing the following policy: Proof of Insurance Waiver
If you have a managed care insurance plan you may be required to provide our office with a referral and/or authorization to visit our doctors. If you do not have a referral/authorization we will require you to read and agree by signing the following policy: Unauthorized Visit Waiver
An existing patient is a patient who has received professional services from Eye Clinic of Austin within the past three years.
Patient Annual Medical History
Patient Registration – English
Patient Registration – Spanish Patient Authorization Form
Authorization for Use or Disclosure of Medical Record Information
Testimonials
Eye Care Blog
In an evolving healthcare landscape, in-office surgery has become an appealing alternative to traditional hospital-based procedures, particularly for patients seeking quality eye care and various eye surgeries, such as corneal transplants or treatment for glaucoma. At Eye Clinic of Austin, our skilled eye doctors address concerns that are related to a range of eye conditions […]
For good vision, the cornea should be transparent, smooth, properly shaped, and healthy. If it is damaged or misshapen, for example, it cannot properly focus the light that enters the eye, leading to glare or blurry vision. If your cornea is beyond repair, a corneal transplant may be a viable solution for you. The surgery […]
Individuals with diabetes are at increased risk of developing certain eye conditions. This includes diabetic retinopathy, a leading cause of blindness in American adults. With proper treatment, the progression of this eye disease can be stopped and vision loss can be prevented. Dr. Irshad is board-certified by the American Academy of Ophthalmology and can help […]