Provident Eye Specialists offers an array of ophthalmology services in town:

• Medical Dilated Eye Exams 
• Cataract / Implant Surgery
• Glaucoma
• Diabetic Eye Care
• Dry Eye / Tearing Problems
• Infection / Injuries
• Eye Emergencies
• Retinal Disorders

FORMS

Please fill out the forms prior to your office visit in order to save you time.



New Patient Forms:

 

New Patient Forms (English)

New Patient Forms (Spanish)



Other Forms:

 

Notice of Privacy Practices (English)

Notice of Privacy Practices (Spanish)


If you have any question regarding to any of the forms, please feel free to contact our office. Someone will be able to answer your questions.

  • -Patient will be dilated, it is recommended to have a driver as your vision will be blurry for up to 3-4 hours.
  • -Bring sunglasses, after the dilation, your eyes will be sensitive to bright lights.
  • -Bring a list of your medications on the day of your visit.
  • -For all cancellations or rescheduling, please call 24 hours prior to the date and time of your appointment. 
  • -For HMO medical insurances, please have your Authorizations done before booking your appointment. 


Learn more about
Dr. Keak Khauv

Call us today and learn how we can improve your vision!

(915) 595-4300

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