An uncommon union of Advanced Personal Eyecare and Fine Optical Boutique

Patient Forms


  To reduce paperwork required before an eye exam, please download and complete the new or established patient forms below.


  1. Current insurance cards - please bring both Major Medical and Vision Insurance.
  2. Current and/or old glasses.
  3. Current sunglasses.
  4. If you wear contact lens, bring in your contact lens box that has contact lens information for each eye.
  5. Appropriate form below.


New Patient Comprehensve Eye Exam

Down load this form for a comprehensive eye exam.

New Patient Contact Lens Exam

If you are getting a contact lens exam, you will also need the comprehensive form. They are two different examination procedures.

Emergency Eye Exams and Treatment

If you are experiencing eye problems, such as an object in your eye, eye ulcer, red eye, dry-eye, alergies, or other issues.



Whitestone Market
2800 East Whitestone Blvd
Suite 210
Cedar Park, TX 78613

Shops at The Four Seasons
305 E. Cesar Chavez
Austin, TX 78701
Email link : click here
Ph. 512.260.9779

Smart phone browswers can use link below