OMIC - Informed Consent Documents

The following forms are in Rich-Text Format (RTF). If you are on a PC, your browser will use a word-processing application such as MS Word to open the document within your browser window. If you are on an Apple computer, the file will be downloaded to a designated folder or your desktop.

Click here for consent forms in Spanish.

General Consent Form with Addendum

General Consent for Medical and Surgical Procedures

Cataract Surgery Consent Forms

Cataract Consent Form
Patient Information Sheet
Cataract Surgery Risk Management Recommendations
Endophthalmitis/TASS Recommendations and AAO/ASCRS Reports

Endophthalmitis/TASS Investigation Protocol

Intraoperative Floppy Iris Syndrome

A syndrome named intraoperative floppy iris syndrome or IFIS has been linked to a medication called Flomax, which is prescribed for men with prostatic hypertrophy and women with urinary retention. Click here to link to an AAO article by Dr.David F. Chang that gives recommendations on how to prepare for and manage it.
Please click here for the AAO/ASCRS Educational Statement:

YAG Capsulotomy

Corneal Surgery

DSEK Corneal Transplant Surgery
Mitomycin-C Treatment for Conjunctival and Corneal Disorders

Courtesy of Bernard H. Chang, MD, a practicing ophthalmologist in Nashville, TN.)

Phototherapeutic Keratectomy (PTK) Consent Form
Pterygium Surgery Consent Form

Glaucoma Surgery Consent Forms

Argon Laser Trabeculoplasty (ALT) Selective Laser Trabeculoplasty(SLT)
Glaucoma Filtering Surgery (Trabeculectomy) Consent Form
Mitomycin-C and 5-Fluorouracil in Glaucoma Filtering Surgery
(Courtesy of B. Thomas Hutchinson, MD, a practicing ophthalmologist in Boston, MA.)
General Consent for Glaucoma Surgery

Oculoplastic/Eyelid Procedures

Botox Use Consent Form
Juvederm Consent Form
Chalazion: Incision and Drainange of Chalazion Consent Form
CO2 Laser Skin Resurfacing Consent Form
GentleMAX Laser Treatment Consent Form (Courtesy of John W. Shore, M.D., a practicing ophthalmologist in Austin, Texas.)
Latisse™ Treatment Consent Form (Courtesy of John W. Shore, M.D., a practicing ophthalmologist in Austin, Texas.)
Punctal Plugs Consent Form

(Courtesy of Bernard H. Chang, MD, a practicing ophthalmologist in Nashville, TN.)

Restylane Injection Consent Form
Tumescent Liposuction Surgery Consent Form

(Courtesy of Emilio M. Justo, MD, a practicing ophthalmologist in Sun City West, AZ.)

Strabismus

Strabismus Surgery Consent Form

Retinal Procedures

Avastin™ Consent Form

Avastin™ Recommendations

Fluorescein Angiography Consent Form

Fluorescein Angiography Recommendations

Lucentis™ Consent Form

Lucentis™ recommendations

Triamcinolone Acetonide Recommendations and Consent form

Miscellaneous Consent Forms

Refractive Surgery Consent Forms

AK Consent Form

Informed Consent for Astigmatic Keratotomy

Conductive Keratoplasty Consent Forms

Intacs Consent Forms

IntraLASIK Consent Form

IntraLASIK Consent

LASIK Consent Forms

Refractive Lens Exchange Consent Form

Informed Consent for Refractive Lens Exchange

Consent for Comanagement After Eye Surgery

(Courtesy of David A. Wallace, MD, a practicing ophthalmologist in Santa Monica, CA.)

Wavefront Addendum
(Courtesy of David A. Wallace, MD, a practicing ophthalmologist in Santa Monica, CA.)