Get the free Ortho-Keratology Screening Form

Nathan BonillaWarford, OD, FAO, FCO VD Elizabeth Knight on, OD, FAO P: (813×7920637 F: (813×7920657 E: office brighteyestampa.com OrthoKeratology Screening Form Name: Date: How did you find out

How to fill out ortho-keratology screening form

1. Start by gathering the necessary information. The ortho-keratology screening form typically asks for personal details such as name, age, address, and contact information. Make sure to provide accurate and up-to-date information.
2. The form may also require you to disclose any relevant medical history or current health conditions. This is important as certain conditions or medications may affect the suitability of ortho-keratology treatment. Be thorough and honest when filling out this section.
3. It is common for the form to include a section where you need to indicate your reasons for seeking ortho-keratology treatment. This helps the healthcare professional understand your goals and expectations, as well as customize the treatment plan accordingly.
4. The form might ask about your visual acuity and prescription details. This information helps the healthcare professional assess your current visual state and determine the suitability and effectiveness of ortho-keratology for your specific needs.
5. If you wear contact lenses or glasses, you may be asked to provide details about your current eyewear prescription. This helps the healthcare professional evaluate any changes that may be required during the ortho-keratology treatment process.
6. Finally, the ortho-keratology screening form could include a section where you can ask any questions or discuss any concerns you may have about the treatment. Use this opportunity to seek clarification or address any reservations you may have.

Who needs ortho-keratology screening form?

1. Individuals interested in pursuing ortho-keratology treatment should complete the screening form. This includes people seeking an alternative to glasses or daytime contact lenses, and those looking to correct their vision while they sleep.
2. Children and teenagers who experience myopia (nearsightedness) and have a prescription within the eligible range are also encouraged to fill out the ortho-keratology screening form. Ortho-keratology has been found to effectively slow down the progression of myopia in growing eyes.
3. Individuals with mild to moderate astigmatism may also benefit from ortho-keratology and should complete the screening form to assess their suitability for the treatment.

Remember, it is essential to consult with a qualified healthcare professional, such as an optometrist or ophthalmologist, who specializes in ortho-keratology, to guide you through the process, discuss your specific needs, and provide personalized advice and treatment options.

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