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REFRACTIVE SURGERY PARK/LAST AGREEMENTComplete Form and Bring to Prepare/Rank: ___ DOD ID#: ___ EARS / ETS: ___ Surgery Date: ___ Recommended Convalescent Leave: 7 days beginning on date of surgery,

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How to fill out refractive surgery consult form

01

Start by providing basic personal information such as name, date of birth, and contact information.

02

Specify any medical conditions or eye diseases you currently have.

03

Detail any medications you are taking or have taken in the past.

04

Describe your vision history, including any previous eye surgeries or treatments.

05

List any allergies you have, especially if they are related to medications or anesthesia.

06

Provide information about your lifestyle and occupation, as these factors can impact the success of the surgery.

07

Include any questions or concerns you have about the procedure or post-operative care.

Who needs refractive surgery consult form?

01

Individuals seeking refractive surgery such as LASIK or PRK will need to fill out a refractive surgery consult form.

02

Patients with refractive errors such as nearsightedness, farsightedness, or astigmatism may also be required to complete this form.

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What is refractive surgery consult form?

It is a form that patients fill out before undergoing refractive surgery to assess their eligibility and risk factors.

Who is required to file refractive surgery consult form?

Patients who are considering undergoing refractive surgery are required to file the consult form.

How to fill out refractive surgery consult form?

Patients can fill out the consult form by providing their personal information, medical history, and reasons for wanting refractive surgery.

What is the purpose of refractive surgery consult form?

The purpose of the consult form is to evaluate the patient's suitability for refractive surgery and to inform them of the potential risks and benefits.

What information must be reported on refractive surgery consult form?

The form may require information such as patient demographics, medical history, current medications, eye health, and reasons for seeking refractive surgery.

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