Open the files by clicking the PDF icon. Please print out the first 4 pages, sign, and bring with you to your eye appointment. The last page (Notice of Privacy Practices-HIPAA) is for you to read only. It details the HIPAA Compliance, which explains your rights and privacy as a patient.

Dilation and Visual Field Screening

Bill of Rights

Acknowledgement of Privacy Practices

Formularios en Español (Spanish-language forms)

Acknowledgement of Privacy Practices

Notice of Privacy Practices - HIPAA

Spanish Forms

Registration and Health History

Patient Forms

Registration and Health History, ​Additional Screenings

Bill of Rights

Notice of Privacy Practices - HIPAA

New Braunfels

Dilation and Visual Field Screening

Austin and San Antonio