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.
New Patient Registration Forms
A new patient is one who has not received any professional services from Eye Clinic of Austin within the past three years.
New Patient Medical History
Patient Registration – English
Patient Registration – Spanish
Patient Authorization Form
Authorization for Use or Disclosure of Medical Record Information
Proof of Insurance Form
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
Existing Patient Registration Forms
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
Awards & Recognition
Awards & Recognition
Testimonials
Eye Care Blog
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