New Patient Forms and Documents

NOTE: These forms can be filled up and printed online. However, your data MAY NOT be saved if your computer is not configured with an option to “Save as PDF” after pressing the “PRINT” button.

If you intend to save your data for edit later on, DOWNLOAD FIRST the form into your computer and fill up using a PDF Reader. Downloaded forms can be filled up and saved for edit later.

New Patient Packet

• New Patient Welcome letter
• Information for Your Driver

• Medical History Form
• Private Contract
• Financial Policy Form
• HIPAA Policy Receipt Form*

Canaloplasty

• Consent for Dilation
• Canaloplasty Consent Form
• Glaucoma Screening Intake*

• Trabeculectomy Glaucoma Surgery After Canaloplasty

Cataract Surgery Pre-op

• Your Cataract Surgery Experience
• Which Cataract Surgery To Choose
• Are You Taking Prostate Medication?

• Preparing for Cataract Surgery*
• Cataract Surgery What You Must Know Before Having It Done
• Choice Of Cataract Surgery
• Cataract Surgery Consent*

Co Management Forms

• Co-Management Consent Form for Optometrist*
• Co-Management Consent Form for Ophthalmologist*
• Consent for Co-Management After Eye Surgery*