	Increase size \| Reduce size OD Network - Doctors Portal

New Patient Info & Referral Information for ODs

HIPPA Form - Patient Acknowledgement for Signature (38.5 KB)
Lifestyle Vision Questionnaire (61.48 KB)
Map to Bellaire Clinic (430.04 KB)
Map to Clear Lake Clinic (437.25 KB)
Map to Katy Clinic (430.15 KB)
Map to Pasadena Clinic (436.55 KB)
Map to Sugar Land Clinic (434.79 KB)
Medical History Form - English (46.66 KB)
Medical History Form - Spanish (16.42 KB)
Referral Form for ODs New Patients to ECT (194 KB)
Welcome Letter (16.46 KB)

Disease of the Eyes - What's It All About? - Patient Handouts

Adenoviral Eye Infection (249 KB)
Cataract, What Is It? (253.5 KB)
Cornea Transplant, What Is It? (267 KB)
Diabetic Patient and Eye Disease (245 KB)
Macular Degeneration Prevention Guide... Vitamins (1.19 MB)
Patient's with Pterygium(s) (232.5 KB)
Pterygium Photo (2.91 KB)
Retina Holes, Tears & Retina Detachment (254.5 KB)
Trabeculectomy, What Is It? (236.5 KB)
Vitamin & Mineral Supplements For Your Eyes (85 KB)
Yag Laser Capsulotomy - What Is It? (223 KB)
Yag Laser Peripheal Iridotomy or YAG (238.5 KB)

Necessary LASIK Forms for the OD and the OD's LASIK Patients

Informed Consent for LASIK Patients (90.5 KB)
LASIK Post Op Form (23.97 KB)
LASIK Post Op Instructions for Patient (44 KB)
LASIK Pre-Op Instructions
LASIK Pre-Op Report (30.67 KB)
Pre Procedure Report (30.67 KB)
Warranty for LASIK patients (56.5 KB)

Refractive Surgery Info to Co-managing ODs and their Patients

Financing with Care Credit (75.5 KB)
LASIK - Cornea Flap Lift Consent (49 KB)
LASIK - Drop Schedule Post Op - English (1.45 MB)
LASIK - Enhancement Informed Consent (89.5 KB)
LASIK - Informed Consent (90.5 KB)
LASIK - Letter to Co-Managing ODs (74.5 KB)
LASIK - Limited Lifetime Warranty (56.5 KB)
LASIK - Medical History Questionnaire (79.5 KB)
LASIK - Monovision Policies (66.5 KB)
LASIK - Post Procedure Report (23.97 KB)
LASIK - Postoperative Patient Management File (1.17 MB)
LASIK - Pregnancy & Nursing Disclosure (63 KB)
LASIK - Pre-Op Instructions (272 KB)
LASIK - Questions & Answers for Patients (41.18 KB)
LASIK - WaveScan & WavePrint System (76 KB)
LASIK -Drop Schedule Post Op - Spanish (1.53 MB)
LASIK Immediate Post Op Exam Report (27 KB)
LASIK Pre-Op Procedure Exam Report (30.67 KB)
PRK Drops - English (888.03 KB)
PRK Drops - Spanish (950.04 KB)
Refractive Patients Registration (61 KB)
LASIK Pre-Op Instructions (272 KB)
Near Vision after LASIK (57.5 KB)
PRK Enhancement Consent (84 KB)
PRK Informed Consent (90.5 KB)
Visian ICL vs Other Refractive Procedures (94.4 KB)

Cataract Forms & Documents - Note we have new drops as of May 2011

Cataract 1 Day Post Op (201.5 KB)
Cataract 1 Week Post Op Forms (210 KB)
Cataract Post Op Check List for OD (258.5 KB)
Cataract Post-Op Instructions (266 KB)
Cataract PreOp Sx Instructions - (286.5 KB)
Custom Intraocular Lens Lifetime Warranty (81.93 KB)
General Follow Up Exam Form for Patient's Chart (45.5 KB)
Informed Consent for Cataract Patient (275 KB)
NEW Cataract Drop Schedule Chart (30.19 KB)
NEW- Cataract Pre & Post Op Drops Info Sheet

Blepharoplasty Forms & Documents

Bleph - Disclosure & Informed Consent for Medical/ (216.5 KB)
Bleph Post Op Home Instructions (237 KB)
Lid Scrub Hygiene - English (269.5 KB)
Lid Scrub Hygiene - Spanish (250.5 KB)
Medical Necessity for Upper Bleph (37.5 KB)

Procedural Information

Minor Surgical Procedure Informed Consent (251.5 KB)
Obtaining a Medical History on Your Patient (30 KB)
PDT/Visudyne Procedure w/Wet orNeovasticular (282.5 KB)
Standard Treatment Protocols (281 KB)
Visual Assessment (29.5 KB)

Intacs Forms & Documents

Informed Consent for Intacs Surgery for Kerato-Eng (325 KB)
Informed Consent for Intacs Surgery for Kerato-Spa (324 KB)
Intacs Candidates - Are You One? (167 KB)
Intacs Post Operative Instructions (293.5 KB)
Intacs Pre Operative Instructions for the Intacs S (285.5 KB)
Intacts - CLEK Study Information Handout (524.48 KB)

Glaucoma Forms & Documents

Glaucoma Consultation Form (281 KB)
Glaucoma Patient's Trabeculectomy Pre Op Orders (281 KB)
Glaucoma SLT Laser Information - Patient Handout (255 KB)
Informed Consent for SLT for Glaucoma - English (262.5 KB)
Informed Consent for SLT for Glaucoma - Spanish (284.5 KB)

Latisse & Botox Information

Botox Cosmetic Questions & Answers (44.5 KB)
Botox Injection Informed Consent (60 KB)
Latisse Evaluation Form (68.1 KB)
Latisse Patient Brochure (743.62 KB)
Love the Long Eyelashes Article - New York Times (92.62 KB)
Patient Guide - How to Use Latisse (85.5 KB)