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
56
resources.
Apr 8, 2026
| Consent Form
...or Phototherapeutic Keratectomy (PTK) performed with the excimer laser. COMPLICATIONS AND SIDE EFFECTS There is no guarantee that the surgery will improve your condition. It may fail to improve your vision or even make it worse. In addition, surgery is risky. Sometimes it can make the original problem worse, cause...
Dec 1, 2025
| Consent Form
...injections, including no treatment, collagen for lip or other facial soft tissue augmentation, and cosmetics, Botox, laser skin resurfacing, chemical peels, or plastic surgery for wrinkle reduction. Results. I understand that the actual degree of improvement cannot be predicted or guaranteed. Furthermore, I understand that the effect will gradually wear...
Mar 19, 2023
| Consent Form
...use these medications “off-label” because they may be similar or even have a better effect compared to an FDA-approved medication. Your ophthalmologist will let you know if other medications, or a similar medication with a different method of delivery, are available for your condition; whether laser or other types of...
Apr 9, 2026
| Consent Form
...an additional IOL, or refractive laser surgery may be needed if you are not satisfied with your vision after cataract surgery. [State any minor problems that could occur following the procedure.] Risks What are the main risks of IOL Exchange Surgery? There is no guarantee that the IOL Exchange surgery...
Apr 22, 2026
| Consent Form
...treat diabetic macular edema. Talk with your eye surgeon about the risks and benefits of these medications. · Laser surgery to treat leaking blood vessels in the eye that might be causing the swelling. Risks (problems this medication may cause). There are risks with the medication, the injection, and the...
Apr 22, 2026
| Consent Form
...total corneal thickness 250 um · Scrape off the epithelium · Perform mild excimer laser phototherapeutic keratectomy to smooth the corneal bed · Apply MMC 0.02% formulation (same as the 0.2mg/mL solution) · Application protocol · Cut out 6 mm disc of filter paper with a trephine · Moisten disk...
These are sample forms—download, review and revise as needed.