Glaucoma Institute of Austin

Patient Information

Important! - When you come to our office for your appointment, please make sure you bring identification, your current insurance card, referral or authorization forms, and any medical records in your possession.

New Patient Forms - If you are a new patient, please download and complete the following forms to save time during your office visit:

Patient Demographics (.PDF* or Word)
Medical Questionnaire (.PDF* or Word)
Acknowledgement of Notice of Privacy Practices (.PDF* or Word)
Patient Financial Responsibility (.PDF* or Word)

Consent Forms

Argon Laser Trabeculoplasty (.PDF* or Word)
Ciliary Body Glaucoma Treatments (.PDF* or Word)
Laser Iridotomy (.PDF* or Word)
Mitomycin (.PDF* or Word)
Trabeculectomy (.PDF* or Word)
Valve Implantation (.PDF* or Word)
YAG Posterior Capsulotomy (.PDF* or Word)
Cataract Surgery (.PDF* or Word)
Bleb Needling (.PDF* or Word)
Selective Laser Trabeculoplasty (.PDF* or Word)

Other Forms

Medical Records Release to GIA (.PDF* or Word)
Medical Records Release from GIA (.PDF* or Word)
HIPAA Notice of Privacy Practices (.PDF* or Word)
Aviso de Practicas Privadas (.PDF* or (Word)

NOTE: If you have trouble downloading these forms, please click on the link (.PDF or Word) with the right-hand button of your mouse, and select "Save target as..."

* .PDF files require the free Adobe Acrobat Reader.

Types of Glaucoma

Diagnosis & Treatment

Glaucoma FAQ

Risk Factors

Managing Glaucoma

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