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
6
resources.
Apr 8, 2026
| Consent Form
...you have obtained informed consent. · Keep the original in the patient’s medical record. Version 11/21/2014 [Your Letterhead] [bookmark: _GoBack]Superficial Keratectomy or Corneal Excision Consent You have anterior basement membrane dystrophy, and your doctor, [Name, MD/DO], is recommending Superficial Keratectomy or Corneal Excision. What is anterior basement membrane dystrophy? ·...
Sep 10, 2026
| Consent Form
...surgical procedures to treat conjunctivochalasis, all of which involve excising the excess tissue, tightening the loose tissue, or replacing the abnormal conjunctival tissue. Conjunctival cautery can be used to create superficial scarring and tightening of the tissue. The abnormal tissue may be excised and new tissue allowed to grow back...
Sep 15, 2026
| Consent Form
...extirpación de tejido con el láser excimer. La QFR consiste en eliminar las células superficiales de la córnea (“epitelio”) y utilizar el láser excimer para eliminar el tejido expuesto en la superficie de la córnea. Se ha demostrado que ambos procedimientos son bastante exitosos y relativamente seguros para la corrección...
Sep 14, 2026
| Consent Form
51723 This form is intended as a sample. It does not constitute the standard of care nor does it provide legal advice. It contains the information OMIC recommends the surgeon personally discuss with the patient. How to use this sample 1. Please modify it to fit your actual practice. 1....
Sep 14, 2026
| Consent Form
...laser surgery, I have been advised by Dr. and understand the items listed below: 1. The surgical removal of the superficial layers of my cornea using the excimer laser has been elected by me as an alternative to other forms of corneal surgery. 2. As with all surgery, I understand...
Sep 14, 2026
| Consent Form
...procedimiento original y puede provocar una disminución de la visión. Las cirugías refractivas como la queratectomía fotorrefractiva (QFR), la queratomileusis subepitelial asistida por láser (QSAL) y la ablación superficial avanzada (ASA), se han asociado con la opacidad corneal en algunos pacientes. Desde 1997, se utiliza un medicamento llamado mitomicina-C (MMC)...
These are sample forms—download, review and revise as needed.