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Patient Center

Welcome to our Online Patient Center. Here you can complete online forms before your appointment to save time.
We want your visit to be as stress-free as possible. Our staff will do everything we can to make sure your experience is pleasant and convenient. If you have any questions about these forms, please don’t hesitate to contact us.

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What to Expect

When you visit our office, you will be warmly welcomed and we can answer any questions you may have about completing the paperwork so that Pupila Family Eye & Ear Care may see you. Our team will work together to evaluate your eyes and provide relevant eye care treatment information, review your vision benefits and payment options, fit you for glasses or contact lenses, and focus on exceeding all of your expectations. If at any time you have questions about the process or your specific health information, please ask.

Patient Forms

Please complete the following online forms.

Book An Appointment
Order Contacts Online
Patient Forms
Patient Portal
Email Us
Welcome Form

Please call the office at least 24 hours before your appointment if you have to reschedule. All cancellations and no-shows after that will incur a $35 fee.

Additional Patient Forms

Amniotic Membrane Consent Form

Pre & Post Radio Frequency (RF) Instructions

Pre & Post Microneedling Instructions

Pre & Post IPL Instructions

Non-Ablative Skin Therapy Consent

Microneedling Consent Form

Intense Pulsed Light (IPL) / RadioFrequency (RF) Consent Form

HIPAA Consent Form

Pre Visit Prep Quiz

Contact our Houston eye care staff to book or request an appointment by filling out one of the forms below. Or email us with your questions or concerns. We look forward to hearing from you.

At Pupila Family Eye Care, we believe that providing quality eye care to our patients is a two-way street, so please let us know where we can make improvements or what kind of services you would like to see in the future. Your feedback is important to us.