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Forms

We ask that all new patients complete our medical questionnaire. The information we request in this form will be extremely valuable to our physicians in providing new patients with the best possible care.

We have included the medical questionnaire on our website because we find some patients feel it is easier to fill out the form prior to their initial visit.  Please bring the completed form with you on your first appointment. Do NOT mail the forms to our office prior to your visit. 

Medical Questionnaire Form

Spanish Forms

If you need your medical records from another physician to be transferred to Texas Regional Eye Center or wanting Texas Regional Eye Center’s medical records to be transferred elsewhere, you will need to fill out a Medical Records Release Form. We have included that form on our website for your convenience. Please print, fill out, and either mail or fax the completed form to the necessary physician/facility.

Medical Records Release Form

Important Information

Please bring the completed paperwork to our office for your first visit.  We also ask that you bring the following items:

  • Insurance Card(s)
  • Photo ID (A driver’s license or school ID will work fine.  If you do not have either of these, bring a picture that is 4×6 or smaller that can get scanned.)
  • Referral from your primary care physician (if required)
  • If you have an insurance plan that requires an authorization number, such as a HMO or United Healthcare Health Select, please verify with our office that the authorization number has been received prior to your visit.  If not, you will have to either self pay for the appointment or reschedule your appointment.
  • Co-pay or any non-covered amount

Our office will call to confirm your appointment the day before you are scheduled to arrive. Driving directions and practice information is also available on our website. 

Thank you very much for your cooperation. This information helps us and helps you be seen in a timely manner. We look forward to seeing you.

If you have any questions, please contact our office.

Thank You!