APPOINTMENT LINE:

713.637.4408

NEW PATIENT FORMS

New Patient data may be completed directly on Macula Vitreous Retina Physicians & Surgeons electronic medical record through the patient portal if you have Chrome or Mozilla Firefox. Our receptionist can enable your access to the patient portal and send an email with your initial password. The patient portal will also allow you access to your clinic notes. A PDF copy of the New Patient Information Form can be downloaded by clicking below. 

Macula Vitreous Retina Physicians & Surgeons

6655 Travis St, Suite 560

Houston, TX 77030

 Tel: 713.637.4408 

Fax: 832.547.2221


NEW PATIENT FORM (PDF)

2017 Copyright Macula Vitreous Retina Physicians & Surgeons, PA

​Unauthorized copy and distribution prohibited

RELEASE OF MEDICAL RECORDS TO MVR-PS

A signed document requesting your medical records to be transferred to Macula Vitreous Retina Physicians & Surgeons, PA must be submitted to the facility/practice where you were previously seen if you wish to make available these records to our practice. Note that it can take up to 3 weeks for a practice to send records. It is especially valuable to have access to your outside records if you have had previous surgery, intravitreal injections or treatment for uveitis (inflammation in the eye). Click below for a form to request release of outside medical records to MVR-PS:

RELEASE OF INFORMATION FORM (PDF)