Risk Management



Kenalog consent form

This sample consent form for Kenalog addresses the off-label status of intravitreal injection of this drug.

RECOMMENDATIONS: Kenalog and Triesence intravitreal injections.

PREVENT WRONG EVENTS: Time out before Intravitreal Injections

 

 

____________________________________________                    ___________________

Patient’s Signature                                                                                                   Date

 

 

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OMIC is the largest insurer of ophthalmologists in the United States and we've been the only physician-owned carrier to continuously offer coverage in all states since 1987. Our fully portable policy can be taken with you wherever you practice. Should you move to a new state or territory, you're covered without the cost or headache of applying for new coverage.

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