Phone: 254-690-4733 • Fax: 254-690-6728
2102 South W.S. Young • Killeen, Texas 76543
Office Hours: Monday - Thursday 10:00 am - 7:00 pm
Friday 10:00 am - 5:00 pm
 
   
OfFice forms

Below you will find all of our office forms that you will need to fill out before you have your eye examination. We realize that filling out forms is never enjoyable, but the information is critically important to us if we are to provide you with eye care, even if you don't understand why we are asking you for certain information. Please answer completely, truthfully and honestly so that we may may provide you with the eye care you deserve. Remember, all of your personal and medical information is confidential and subject to our Notice of Privacy Practices, and we take very seriously matters of doctor - patient confidentiality.

You may fill out these forms in our office fifteen (15) minutes before your scheduled appointment, but it is much preferred to print the forms at home and fill them out at your leisure. If you have multiple family members that need eye examinations, filling out the forms at home will greatly help our staff when your family arrives for their appointments. Simply present the completed forms to our staff when you arrive, and we can begin your eye examination process in a more timely manner.

You will also find our Notice of Privacy Practices, along with a Records Release Authorization, that is required if you want us to obtain old records from a previous doctor on your behalf.

 

 
 
 
 
 
 
 
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