Retina and Vitreous of Texas Logo
713-799-9975
Patient Portal
Book Now

  • Home

  • Our Physicians

    • Dr. Khawly
    • Dr. Holz
    • Dr. Rahman
    • Dr. Chang
    • Dr. Tzu
    • Dr. Rao

  • Locations

    • Houston
    • Katy
    • Conroe
    • Beaumont
    • Pearland
    • Victoria
    • Lufkin
    • Tomball
    • Brenham
    • Sugar Land
    • Humble

  • Diseases & Treatments

    • Retinal Condition Fact Sheets

  • Pay Bill

  • Insurance

  • Fellowship Program

  • Testimonials

  • Clinical Trials

  • Resources

  • Patient Forms

  • FAQ

  • Houston Pediatric Retina

  • More

    Use tab to navigate through the menu items.

    Forms

    English Patient Forms

    Forms%20Vector%20Art_edited.png

    New Patient Forms
    (Submit Online)

    Patient Forms 
    (Printable Only)

    Financial Policy

    ​

    Notice of

    Privacy Practices

    "Good Faith Estimate"

    Formas de Pacientes en español

    Forms%20Vector%20Art_edited.png
    Nuevas Formas de Pacientes
    (Sumisión en línea)

    Formas del Paciente
    (Versión Imprimible)

    Ley de No Sorpresa - "Estimado de Buena Fe"

    Phone: (713) 799-9975  |  Fax: (713) 799-1095

    ~

    • Facebook
    • LinkedIn
    • Instagram

    Retina & Vitreous of Texas

    ©2022 by Retina & Vitreous of Texas