Online Patient Forms

Please click on above link to portal for filling out patient forms online. Please call office if you have any questions or need any help. Thank you

Paper Patient Forms

NEW PATIENT FORMS

If you prefer to fill out your information on paper, download and complete these new patient registration forms​. Bring the completed paperwork to your appointment.

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 prefer paper and is 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.

Willow Bend Vision Care

(972) 202-5632

(972) 202-5630 (fax)

6121 W Park Blvd D120
Plano, TX 75093, USA

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