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Consent Forms

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Last Updated
28th of February, 2009

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The following procedure-specific consent forms have been adapted from the consent forms that are available from the Ophthalmic Mutual Insurance Company. http://www.omic.com/resources/risk_man/forms.cfm

These forms are posted on our site for our patients to review prior to glaucoma or cataract laser or incisional surgery to make sure they fully understand the risks, benefits, and alternatives to the proposed treatment.

Incisional Glaucoma Surgery
Glaucoma surgery consent form
Additional consent when Mitomycin used for glaucoma surgery
Refusal of recommended treatment form

Glaucoma Laser Procedures
Selective Laser Trabeculoplasty (SLT) consent form
Laser iridotomy consent form
Diode laser ablation of ciliary body (Cycloablation) consent form

Cataract Surgery and Laser Procedures
Extensive patient information sheet for cataract surgery
Cataract surgery consent form
YAG Capsulotomy consent form

Attachments

Patient information for cataract surgery.pdf (129,479 bytes)
Laser iridotomy consent form.pdf (92,618 bytes)
Antimetabolites in Glaucoma Surgery.pdf (92,503 bytes)
Selective Laser Trabeculoplasty consent form.pdf (82,921 bytes)
Cataract surgery consent form.pdf (87,541 bytes)
Diode Laser Cycloablation consent form.pdf (91,005 bytes)
Glaucoma Consent Form.pdf (98,839 bytes)
Refusal of recommended treatment.pdf (95,450 bytes)
YAG Capsulotomy consent form.pdf (81,179 bytes)