Forms

Consent Forms

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

Other forms

CCRA Disability Tax Credit printable
CCRA Disability Tax Credit FILLABLE

Additional forms coming in 2021