Online Forms

Patient Forms

To help speed the initial registration and familiarization process, we have made our new patient forms available for download here. Click on the links below to print and fill out the forms at home. Please fax or email them to our office prior to your appointment.

PDF File
Protected Health Information
PDF File
Release of Health Information
PDF File
HIPAA Consent Form
PDF File
Statement of Privacy
PDF File
Adult Intake Form
PDF File
Pediatric Intake Form
PDF File
Neuro-optometric Intake Form
PDF File
Strabismus & Amblyopia Form
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Conditions We Treat

If you or your child is experiencing any symptoms that lead you to think that your struggles are visual in nature, it's important to take action and seek treatment as soon as possible.

Keep In Touch

Don't wait – contact us today to schedule an appointment and take the necessary steps towards improving your vision and your performance!

Texas Vision Therapy
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Our Services
Contact Info
Hours of Operation
  • Monday 9:00 AM - 6:00 PM
  • Tuesday 9:00 AM - 6:00 PM
  • Wednesday 9:00 AM - 6:00 PM
  • Thursday 9:00 AM - 6:00 PM
  • Friday 9:00 AM - 6:00 PM
  • Saturday Closed
  • Sunday Closed
  • Monday
  • Tuesday
  • Wednesday
  • Thursday
  • Friday
  • Saturday
  • Sunday
  • Monday
  • Tuesday
  • Wednesday
  • Thursday
  • Friday
  • Saturday
  • Sunday
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