Consent Forms
Welcome to OMIC’s Consent Form library, a collection of procedure-specific consent forms that you can modify to suit your practice and patient population. Contact riskmanagement@omic.com with questions.
Found
3
resources.
May 10, 2023
| Consent Form
...for Comanagement after LAL Cataract Surgery Patient Name: ____________________________ Date of Birth: ___________ Patient Confirmation I understand that my ophthalmologist, Dr. ______________, will be performing eye surgery on me and optometrist, Dr. ________________, will be co-managing my postoperative care. My surgeon has discussed this postoperative care selection with me and...
Jul 9, 2018
| Consent Form
...you have obtained informed consent. · Keep the original in the patient’s medical record. Version —October 2023 Consent for planned comanagement after eye surgery Patient Name: Dr. ___________________ (name of surgeon) will be performing ________________ (type of surgery) on me. Because of __________________ (state reason), I would like Dr. __________...
Oct 11, 2013
| Consent Form
...you have obtained informed consent. · Keep the original in the patient’s medical record. Version —October 2011 Sample Patient Informed Consent to Co-Management of Postoperative Care This will confirm that my surgeon has informed me that I have the right to be seen by him/her during the entire postoperative period....
These are sample forms—download, review and revise as needed.