Call: TX (713) 795-0705 | FL (850) 473-0990 | Toll Free (844) 958-2020
  • Patient Reviews
  • Patient Portal
Plastic Eye Surgery Associates
  • About Us
    • Our Team
      • Dr. James Patrinely
      • Dr. Charles Soparkar
    • Why Us
      • Our Experience
      • Our Accolades
      • Our Promise
      • Patient Reviews
    • Our Practice
      • Media
      • Events & Specials
  • Services
    • Cosmetic Procedures
      • Lower Eyelid Aesthetics
      • Upper Eyelid Aesthetics
      • Ptosis (Droopy Eyelid)
      • Male Aesthetics
      • Eyelid Reshaping
      • Brow / Forehead Lift
    • Reconstructive Procedures
      • Blepharospasm Treatment
      • Corrective Plastic Surgery
      • Earlobe Surgery
      • Entropion/Ectropion Repair
      • Eyelid Reconstruction
      • Eyelid Skin Cancer Reconstruction
      • Orbital Trauma and Fracture Repair
      • Orbital Tumors
      • Ptosis Repair (Droopy Eyelid Surgery)
      • Thyroid Eye Disease
      • Tearing
    • Cosmetic Injectables
      • Dermal Fillers
      • Botulinum Toxin
      • Other Injectables
  • Gallery
    • Cosmetic
      • Female Blepharoplasty
      • Male Blepharoplasty
      • Lower Blepharoplasty
      • Revision of Complications
    • Reconstructive
      • Ptosis Repair
      • Eyelid Retraction
      • Ectropion / Entropion Repair
      • Thyroid Eye Disease
      • Orbital Reconstruction
      • Mohs Reconstruction
      • Earlobe Repair
  • Resources
    • Education Center
      • Thyroid Eye Disease Video Series
      • Educational Videos
      • Products
      • FAQs
    • Patient Resources
      • Patient Education
      • Patient Forms
      • Patient Links
      • Financial Policy
      • Patient Portal
  • Locations
    • Florida
      • Destin Office
      • Pensacola Office
    • Texas
      • Houston Office
      • The Woodlands Office
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Resources

Patient Forms

Patient Forms

As a courtesy to our patients, we’ve made available these helpful forms and information packets. Simply click on the links below to view each PDF.

Patient Registration Forms
    • Follow UP Patient Registration Packet
    • NEW Patient Registration Packet

 

Accepted Insurance
  • Dr. Soparkar Houston Texas Insurance
  • Dr. Patrinely Houston Texas Insurance
  • Dr. Patrinely Florida Insurance
Photos and Videos
  • Taking Standardized Photos at Home
  • TED Videos Instructions
COVID-19 Forms
  • Viral Infection Risk Assessment
  • COVID-19 Risk Awareness
Patient Consent Forms and Medical Records Request
  • LATISSE Consent Form
  • Telemedicine Consent
  • Medical Records Request Release Form From Us
  • Medical Records Request Release Form To Us
Handouts in Spanish
  • Cirugia Del Conducto Lagrimal
  • Tratamiento de La Blefaritis Posterior
  • Rosacea/Hiperplasia Sebacea Protocolo
  • Instrucciones Despues De Una Semana De Cirugia
  • Información Post-Operativa Del Paciente
         Cirugía del Parpado
  • Información Post-Operativa Del Paciente Cirugía Menor
  • Oftalmopatia de la Tiroides

Patient Resources

  • Patient Education
  • Patient Forms
  • Patient Links
  • Financial Policy
  • Patient Portal

Education Center

  • Thyroid Eye Disease Video Series
  • Video Resources
  • Products

Contact Us

If you would like to consult with our doctors about a cosmetic surgery procedure, contact us.

Contact Us

our locations

RECOGNIZED LEADERS IN EYE AND FACIAL PLASTIC SURGERY

Untitled 17

Houston, TX

3730 Kirby Drive, Suite 900
Houston, TX 77098

713-795-0705

Untitled 14

The Woodlands, TX

9180 Pinecroft, Suite 250
Medical Plaza 4
Shenandoah, TX 77380

713-795-0705

Untitled 15

Pensacola, FL

17 E. Main St. Suite 100
Pensacola, FL 32502

850-473-0990

Untitled 16

Destin, FL

4012 Commons Drive West #110
Destin, FL 32541

850-473-0990

Schedule

Cosmetic Procedures

  • Eyelid Reshaping
  • Ptosis (Droopy Eyelid)
  • Upper Eyelid Aesthetics
  • Lower Eyelid Aesthetics
  • Brow / Forehead Lift
  • Male Aesthetics

Injectables

  • Dermal Fillers
  • Botulinum Toxin
  • Other Injectables

Reconstructive Procedures

  • Blepharospasm Treatment
  • Corrective Plastic Surgery
  • Earlobe Surgery
  • Entropion/Ectropion Repair
  • Eyelid Reconstruction
  • Eyelid Skin Cancer Reconstruction
  • Orbital Trauma and Fracture Repair
  • Orbital Tumors
  • Ptosis Repair (Droopy Eyelid Surgery)
  • Thyroid Eye Disease
  • Tearing

Our Team

  • Dr. Charles Soparkar
  • Dr. James Patrinely

Why Us

  • Our Experience
  • Our Accolades
  • Our Promise
  • Patient Reviews

Our Practice

  • Events & Specials

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