New Patient Forms (required for first visit – Please print ALL):
- HIPAA Consent Form
- Patient Registration Form
- Insurance Benefits and Financial Policy
- Authorization Form for Release of Protected Health Information to Individual
*Lakeway Eye Physicians and Surgeons accepts most major insurance plans. Please contact your insurance company to verify provider participation.
Lakeway Eye Physicians and Surgeons will file your insurance claim as a courtesy to you. There is no guarantee that payment will be made for services rendered. If you need a referral from your Primary Care Physician, it is your responsibility to obtain one.
Note: These files are in PDF format. If you do not have Adobe® Reader® on your computer, you can download it for free by clicking here or on the Get Adobe Reader icon.