Patient information and forms are available for you to download, print, fill out, sign and return on your next visit. 

 

Forms are created in PDF Format. Adobe® Reader® software is the global standard for electronic document sharing. It is the only PDF viewer that can open and interact with all PDF documents.

 

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NEW PATIENT FORMS

Assignment of Medicare Benefits - Print & Fill Out

Financial Assignment Sheet - Print & Fill Out

HIPAA Notice of Privacy Practices - Print & Fill Out

Patient Information Sheet - Print & Fill Out

Patient Medical Information - Print & Fill Out

 

HIPAA Compliance Plan

HIPAA Security Plan

Red Flag Rule Policy

Map - Katy Office

 

 

SURGERY FORMS

Cataract Surgery Questionnaire - Print & Fill Out

 

 

LASER VISION CORRECTION FORMS

CustomVue Advantage Patient Information Booklets

Facts You Need to Know About CustomVue™ Laser Assisted

In-Situ Keratomileusis (LASIK) Laser Treatment.  Please read the patient information booklet completely. Discuss any questions with your doctor before you decide if CustomVue LASIK is right for you. Only an eye care professional trained in laser vision correction can determine whether you are a suitable candidate.

Patient Information Booklet for High Myopia (Nearsightedness)

Patient Information Booklet for Myopia (Nearsightedness)

Patient Information Booklet for Hyperopia (Farsightedness)

Patient Information Booklet for Mixed Astigmatism

Patient Information Sheet - VISX Wavefront-Guided LASIK for Correction of Myopic, Hyperopic, and Mixed Astigmatism

 

 


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Columbus Eye Associates

Columbus Optical

   Columbus                             Katy                            La Grange                          Sealy

            979-732-5771               281-829-3937               979-968-3953               979-885-0665     

 Quality Eye Care Since 1953

 

 

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