Please use our patient portal to fill out or update your medical and demographic information
Alternatively, if you choose not to use our electronic patient portal please print and complete the following medical and demographic forms
Refractive Surgery Questionnaires
New Patient Forms
- New Patient Demographics
- Medical New Patient Form
- Austin Eye Payment Policy
- HIPAA – Authorization Consent Form
Established Patient Forms
HIPAA Notices and Forms
All forms are in Adobe PDF format
Use this link to download the Free Adobe Acrobat S
We understand and value your privacy. Austin Eye does not sell or distribute contact information. All data collected through any website form is used only to provide you with better customer service.
At Austin Eye, we leverage cookie-based technology to group users into re-marketing audiences who have expressed an interest in our procedures by accessing key pages throughout our website. We do not collect any personally identifying information with this cookie. Audience members may be shown Austin Eye text and/or image ads on any 3rd party Internet sites or applications for a limited period of time. Visitors may opt out of re-marketing by visiting Ads Settings.