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DILATION FORM
WE PREFER TO DILATE
When indicated, pupillary dilation improves our doctor\'s ability to examine the internal structures of
the eye for signs of disease, which is important for your
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How to fill out dilation form
How to fill out dilation form
01
To fill out a dilation form, follow these steps:
1. Start by providing your personal information such as name, contact details, and date of birth.
2. Next, enter the details of the medical practitioner who will be performing the dilation procedure.
3. Specify the purpose of the dilation form, whether it is for a medical examination or a surgical procedure.
4. Include any relevant medical history or pre-existing conditions that the healthcare provider should be aware of.
5. Indicate the date and time of the dilation procedure, as well as any specific instructions or preparations required.
6. Review the form for accuracy and completeness before signing and dating it.
7. Make a copy of the completed form for your own records and submit the original to the healthcare provider as instructed.
Who needs dilation form?
01
The dilation form is typically required by individuals who are scheduled to undergo a dilation procedure. This can include patients who need to have their eyes dilated for an eye exam, or individuals who are undergoing a medical or surgical procedure that involves dilation of a certain body part. It is important to consult with the healthcare provider or the specific institution to determine if a dilation form is necessary in your case.
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