Risk Management

Consent for Proxy Forms

Minor-aged patients are often brought to the pediatrician for non-urgent acute medical care or health supervision visits by someone other than their custodial parent or guardian. These surrogates can be members of the child’s extended family, such as a grandparent, aunt, noncustodial parent, stepparent, au pair or nanny.  There are two forms available to assist you with obtaining permission or consent from someone other than the custodial parent or legal guardian.

CONSENT FOR PROXY FOR NON-URGENT PEDIATRIC CARE is available for download (proxy click here).

PREAUTHORIZATION TO TREAT MINORS is available for download (pre-authorize click here).




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Six reasons OMIC is the best choice for ophthalmologists in America.

#4. Largest insurer in the U.S.

OMIC is the largest insurer of ophthalmologists in the United States and we've been the only physician-owned carrier to continuously offer coverage in all states since 1987 (pending in WI). Our fully portable policy can be taken with you wherever you practice. Should you move to a new state or territory, you're covered without the cost or headache of applying for new coverage.