Patient Resources

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.