OD Referral Forms and Maps
Patient Care Referral Form
Bellaire Map
Pasadena Map
Clear Lake Map
Sugar Land Map
Katy Map
Woodlands Map
All Locations
Necessary Forms for LASIK Patients
Informed Consent for Lasik Patients
LASIK – Post Op Drops Form
LASIK Post Op Form
LASIK Post-Op Instructions for Patients
LASIK Pre-Op Report
Lifetime Limited Warranty
Refractive Surgery Forms (LASIK)
LASIK Mono Vision Policies
Pregnancy Nursing Disclosure
The WaveScan WavePrint System
LASIK Pre-Op Patient Instructions
Near Vision
Driver’s License Changes After LASIK
EVO Visian ICL vs Other Procedures
Refractive Surgery Forms (PRK)
New Patient Forms
HIPAA – English
HIPAA – Spanish
Lifestyle Vision Questionnaire – English
Lifestyle Vision Questionnaire – Spanish
Medical History Form
Medical History Spanish
Visual Assessment Questionnaire – Right
Visual Assessment Questionnaire – Left
Visual Assessment Questionnaire Spanish
Welcome Letter
Billing Policy
Disease of the Eyes – Patient Handouts
Adenoviral Eye Infection
Cataract, What Is It
Diabetic Patient and Eye Disease
Macular Degeneration Prevention Guide… Vitamins
Retina Holes, Tears and Retina Detachment
Trabeculectomy, What Is It
YAG Laser Capsulotomy
Yag Laser Peripheal Iridotomy or YAG
Cataract
Cataract 1 Day Post Op
Cataract 1 Week Post Op Forms
Cataract Post Op Check List for OD
Cataract Post-Op Instructions
Cataract PreOp Sx Instructions
Custom Intraocular Lens Lifetime Warranty
General Follow Up Exam Form for Patient’s Chart
Informed Consent for Cataract Patient
Generic vs Brand Cataract Drops
Before and After Cataract Instructions and Drops
LenSx Laser Patient Education Brochure
Blepharoplasty
Bleph – Disclosure and Informed Consent for Medical
Bleph Post Op Home Instructions
Lid Scrub Hygiene – English
Lid Scrub Hygiene – Spanish
Medical Necessity for Upper Bleph
Glaucoma
Glaucoma Consultation Form
Glaucoma SLT Laser Information – Patient Handout
Informed Consent for SLT for Glaucoma – English
Informed Consent for SLT for Glaucoma – Spanish
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Our Locations
Houston/Bellaire
6565 W. Loop S., Suite 650Bellaire, TX 77401
Medical Office:
713-797-1010
Medical Fax:
713-357-7276
LASIK/Near Vision:
Office: 713-395-1515
Fax: 713-357-7278
Pasadena
4415 Crenshaw RoadPasadena, TX 77504
Medical Office:
281-977-8800
Medical Fax:
281-977-8877
Sugar Land
15400 S.W. Freeway, Suite 301Sugar Land, TX 77478
Medical Office:
281-277-1010
Medical Fax:
281-277-4504
Clear Lake
455 E. Medical Center Blvd., Suite 110Webster, TX 77598
Medical Office:
281-332-1397
Medical Fax:
281-282-9152
Katy
Greenhouse Medical Plaza2051 Greenhouse Road, Suite 110
Houston, TX 77084
Medical Office:
713-797-1010
Medical Fax:
713-357-7276
The Woodlands/Conroe
100 Medical Center Blvd., Suite 118Conroe, TX 77304
Medical Office:
713-797-1010
Medical Fax:
936-647-1620
