Killeen Eyecare Center - Patient Forms

Patient Forms

We value your time and would like to make your visit to Killeen Eyecare Center as convenient and easy as possible. To save time at your appointment, please fill out the approrpiate forms and bring them with you.

Note: You can fill out these forms by clicking on the blank and typing your information. Then, print the form and bring it to your appointment.

For New Patients:

General Patient Infomation (3 pages)
Patient Consent (1 page)
Privacy Acknowledgement (5 pages)
Patient History Questionnaire (3 pages)
Notice of Privacy Practices (1 page)
Dilation & Photography Consent
(1 page)

For TRICARE Patients:

Non-Covered Services Waiver (2 pages)

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