Cataract and Laser Center Patient Forms. Financial Policy, Patient Bill of Rights - eyecareofdelaware.com

Patient Information > CLC Surgical Patient Forms

CLC Surgical Patient Forms

1. Catarct Pre-Op Instructions for Same Day Surgery and Forms (includes):

  • Pre-Operative Instructions for Cataract Surgery
  • Lens Options for Patients
  • Patient Registration
  • Privacy Authorization and Assignment of Benefits
  • Patient Health Questionnaire
  • History and Physical Form with Cover Letter
  • Financial Policy and Patient Bill of Rights

2.  Pre-Operative Instructions for YAG Laser Surgery (for secondary membrane after cataract surgery)

3. History and Physical Form for Surgical Patient

  • Cover letter attached with instructions for primary care physician.
  • All surgical patients must be cleared for surgery no more than 30 days prior to procedure.

5. Patient's Bill of Rights and Financial Policy
 

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