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
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

Testimonials

Cataract Surgery Patient 7

“He has the best bedside manner, his staff is wonderful, and I’m so glad I did it with him — he’s great.”

Cataract Surgery Patient

Cataract Surgery Patient 6

“The surgery was miraculous! I mean, as soon as he was through, I could already see better. I just can’t say it enough — I’m so happy with it.”

Cataract Surgery Patient

Cataract Surgery Patient 5

“When I got the surgery, even as my eyes were healing, I noticed things were very vivid, very clear.”

Cataract Surgery Patient

Cataract Surgery Patient 4

“The surgery with Dr. Irshad was like nothing. It was over so quickly! I didn’t have to do anything except just lay there and it was really easy.”

Cataract Surgery Patient

Cataract Surgery Patient 3

“Your eyes are pretty precious and you have to trust the people that are going to be working on them, and definitely the group here is great.”

Cataract Surgery Patient

Cataract Surgery Patient

“My vision is totally clear. I can see everything. Everything is just plain as day... It was effortless. Everything went so smoothly.”

Cataract Surgery Patient

Cataract Surgery Patient 2

"The whole world is a lot crisper and clearer and more beautiful to me right now... The whole practice is just professional and wonderful to deal with and completely gave me confidence. I’ve sent a few people over here already. I rave about this place."

Cataract Surgery Patient
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Eye Care Blog