Patient Forms

Access our patient forms that you can fill out before your next visit to Deer Park Vision Source in Deer Park.

Our Forms

• New Patient Form [Web]
• New Patient Form (part 1) [PDF]
• New Patient Form (part 2) [PDF]
• New Patient Form (part 3) [PDF]
• New Patient Form (part 4) [PDF]
• HIPAA Privacy Notice [PDF]
• Nondiscrimination Statement and Language Access Services [PDF]
• Non-Discrimination Grievance Procedures [PDF]