Patient Registration Form

There are three ways to complete your New Patient Registration forms:

  1. Through our secure contact-less portal, Promptly. You will also be able to verify your appointment, check balances, and update forms and insurance cards in this portal. If this is your first time logging in, please contact our office for a personalized link to Promptly.

  2. By filling out paper forms in our office when you arrive for your appointment.

  3. Right here on our website, by filling out the form below.

Online Patient Registration Form

There are several steps to successfully completing this form. For the best experience, please fill out the form using Google Chrome.

  1. Before you begin completing this form, please scroll to the bottom of the page and click the blue continue button. This will make the form turn from gray to white and the highlighted fields will then be clickable.
  2. Once the mandatory red asterisk fields are complete, a blue click to sign box will appear.
  3. After you click the blue box, you will be prompted to enter your email address.
  4. Please check your inbox for an email from Adobe Sign and click confirm my email address.
  5. Your new patient paperwork is now complete and has been securely submitted directly to our office.
  6. Once the welcome desk team reviews your paperwork, a copy will be emailed to you from Austin Retina.


If you have any issues with the steps listed, please contact our office at (512) 451-0103, option 1, and a team member will gladly assist you.