Hurst Eye Center

Specializing in Diseases & Surgery of the Eye
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New Patients

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 and complete the following forms:
 



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 right for a free download.  This will take you to Adobe's website and enable you to download the Acrobat program to your computer.

 

 

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)