Consent Forms
Welcome to OMIC’s Consent Form library, a collection of procedure-specific consent forms that you can modify to suit your practice and patient population. Contact riskmanagement@omic.com with questions.
Found
6
resources.
Apr 22, 2026
| Consent Form
...about Eylea. Here is more information about the warning. New tests on animals show that intravenous Eylea (given directly into the vein) may not be safe for the fetus. Eylea was recently tested on pregnant rabbits. The rabbits were given very high doses of Eylea every three days. The Eylea...
Apr 22, 2026
| Consent Form
...eye problems with a medication called Eylea. Eylea can help decrease vision loss due to 2 types of eye problems: 1) The growth of harmful blood vessels in your eyes 2) Swelling in the back of the eye (macular edema) Eylea is given by an injection (shot) into the back...
Oct 25, 2023
| Consent Form
...you have obtained informed consent. · Keep the original in the patient’s medical record. Version 10/25/23 [Your Letterhead] Informed Consent for Intravitreal Injection of Eylea®HD 8mg (aflibercept) How Eylea®HD 8mg treats your condition Because you have [Condition], your ophthalmologist, [Name], [M.D./D.O.], is recommending Eylea®HD 8mg, an anti-VEGF medication. Ophthalmologists use...
Mar 9, 2023
| Consent Form
...an alternative to laser surgery, ophthalmologists can inject anti-VEGF medication into the baby’s eye to treat ROP. This is called an intravitreal injection. There are many anti-VEGF medications but the ones which are used to treat ROP include Avastin (bevacizumab), Eylea (aflibercept), and Lucentis (ranibizumab). The ophthalmologist will talk to...
Apr 22, 2026
| Consent Form
...animals show that drugs like Lucentis given directly into the vein may not be safe for the fetus. Two drugs called Avastin and Eylea were recently tested on pregnant rabbits. The rabbits were given very high doses of these drugs every three days. The drugs were injected directly into the...
Apr 24, 2026
| Consent Form
...option. Your other treatment choices may include: · Two other medications are approved by the Food and Drug Administration (FDA) to treat RVO and DME: LucentisTM (ranibizumab) and EyleaTM (aflibercept). Some eye surgeons use an anti-VEGF drug called AvastinTM (bevacizumab) to treat AMD and refractory macular edema; this use of...
These are sample forms—download, review and revise as needed.