979-774-0498 (office) or 979-774-0499 (optical)

Forms for your Visit to Texas Regional Eye Center
For your convenience we now offer three ways for you to complete the forms necessary for your visit to Texas Regional Eye Center . You may fill the forms out at our office, but if you prefer a faster method, you can now complete the same forms online, or download them and fill them out at your convenience
Important Information
Please fill out the forms & bring them to your scheduled appointment at our office.

Do NOT mail the forms to our office prior to your visit.

Please bring a picture ID. A drivers license or school ID will work fine. If you do not have either of these id's, bring a picture that is 4 x 6 or smaller.

You must bring your insurance card or cards to your office visit.

If you have an office co-pay, please bring your co-pay to your office visit.

If you have an insurance plan that requires a referral number, such as an HMO or Medicaid PCCM, please verify with our office that the referral number has been received prior to your visit.

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

If you have any questions, please contact our office. Thank you!
Option #1: Fill out the forms online
Through our new online forms section, you can fill out each of the necessary forms safely and securely and print them directly on your home printer. To get started, click here.
Option #2: Download the forms and fill them out manually
Please download the files below and fill them out prior to your scheduled office visit. All forms are in the popular .pdf format.
Current forms available:
Option #3: Fill out the forms at our office.
If you prefer, you can always come by our office and fill out the forms in the comfort of our waiting room. Please allow a few extra minutes, however, to give you time to complete the forms.