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


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 questions regarding the forms, please feel free to contact our office. Someone will be able to answer your questions.

  • • Patient(s) will be dilated, it is recommended to bring have a driver bring you to your appointment 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 your photo ID and health insurance card(s).
  • • If you are taking any medications, please bring a list with you during your appointment.
  • • For all cancellations or rescheduling, please call within 24 hours prior to the date and time of your appointment to avoid a $25 no show fee. 
  • • For HMO medical insurances, please have your Prior Authorizations done before booking your appointment. A Prior Authorization can be obtained from your Primary Care Physician. 

Learn more about
Dr. Keak Khauv

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

(915) 595-4300

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