©2016 BY WILLOW BEND VISION CARE. PROUDLY CREATED WITH WIX.COM

Willow Bend Vision Care

(972) 202-5632

(972) 202-5630 (fax)

6121 W Park Blvd D120
Plano, TX 75093, USA

Patient Forms

NEW PATIENT FORMS

Download and complete the new patient registration forms​. Bring the completed paperwork to your appointment to minimize wait time.

NOTICE OF PRIVACY PRACTICES

​​Your own personal copy of the our Notice of Privacy Policy may be found below. These following pages may be kept for your records and DO NOT need to be brought in to your appointment with your registration forms.

ESTABLISH PATIENT FORMS

If you are a current patient of ours, please fill out the establish patient forms. Please fill out new patient forms if you have not been to office in over 3 years.

RECORD RELEASE FORM

Would you like your previous doctor to send us your records? Authorize the release of your private medical records to us or another office with this form.