Patient Forms

To save you time during your visit, Texas Eye and Laser Center and Texas Eye Surgery Center offers our New Patient Forms online. Filling these out in advance of your first visit will minimize the time you spend in the waiting room when you get here.

If you’re not sure which forms you need, please call 817-540-6060 for assistance.

New Patient Forms

Medical History
Signature on File Generic

Surgery Center Forms

If you are scheduled to have surgery at Texas Eye Surgery Center, please complete the following form(s) at your earliest convenience. Once complete – please send these forms electronically by emailing them to preopnurse@lasikdr.com!

TESC Medical History & Medicine List

TESC Pre-Op Instructions (Read Prior to nurse calling you)

TESC Medical Clearance for Surgery (if required)

Are You a LASIK Candidate?
> Take the Online Self-Test
Are You a cataract surgery Candidate?
> TAKE THE ONLINE SELF-TEST
Understand the cost of LASIK
> USE OUR LASIK SAVINGS CALCULATOR
Are You a LASIK Candidate?
> Take the Online Self-Test
Are You a cataract surgery Candidate?
> TAKE THE ONLINE SELF-TEST
Understand the cost of LASIK
> USE OUR LASIK SAVINGS CALCULATOR