Hurst Eye Center & Rockwall Eye Associates

Specializing in Diseases & Surgery of the Eye

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New Patient Forms 

The following forms can be downloaded to your computer and printed at home.  By filling out these forms ahead of time, you will save significant time during your visit.  If you have any questions when filling out these forms, please do the best you can.  Our staff will assist you with your questions on the day of your visit.
 
Please print out, complete and bring the following 5 forms to your first visit:
 


Cataract Patients

Please print out, review and bring the following forms with you. The Lifestyle lens disclosures should be reviewed; however, until your eyes have been examined and your visual preferences noted, it is premature to sign any one of these forms.

Lifestyle Lens Disclosure Forms:

LASIK/PRK Patients
Please review the "General Information for LASIK Patients" sheet, and print and bring "Screening Questions for LASIK" with you to your visit. The other forms listed should be reviewed; however, until your eyes have been examined and your options determined, it is premature to sign any of these forms.


Specialty Surgery Center Forms:


What to bring to your appointment:

 

  • Your insurance card
  • Your driver's license
  • A list of medications including the dose and frequency
  • All completed patient forms (see above)
  • Referral forms from your doctor (if any)

 

 

 

Need Adobe Acrobat Reader to view these forms?

 

These forms are in PDF format and requires Adobe Acrobat Reader to view.  If you do not have Adobe Acrobat on your computer, click the Adobe icon on the left for a free download.  This will take you to Adobe's website and enable you to download the Acrobat program to your computer.