Patient Forms

Please fill in and print out the appropriate forms below and bring them with you to your initial appointment. You may click on the forms you wish to download as printable PDF files.

Click any form to view or print it:

New Patients

	New Patient Information Form
	Patient History Questionnaire
	Financial Assignment & Agreement

Laser

ClearSight Laser Center Information & Driving Directions

	LASIK Pre-Op/Post-Op Instructions
	Informed Consent for LASIK

	LASEK/PRK Pre-Op/Post-Op Instructions
	Informed Consent for LASEK/PRK

Cataracts

Pre-Operative

	Pre-Operative Instructions for Cataract Surgery
	Pre-Operative Eyedrop Medication Instructions for Cataract Surgery

Post-Operative

Please follow your specific doctor's post-operative guidelines and medication instructions:

	Post-Operative Guidelines for Cataract Surgery
	Post-Operative Medication Instructions for Cataract Surgery

	Post-Operative Guidelines for Cataract Surgery
	Post-Operative Medication Instructions for Cataract Surgery

Surgery

	Consent for Surgery
	Anesthesia Services Consent Form
	History and Physical Medical Clearance Form
	Patient Satisfaction Survey

Contact Lens

Contact Lens Instruction Form

Macular Degeneration

Amsler Grid

Blepharitis and Stye/Chalazion

Hot Compress and Eyelid Hygiene

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Please Note: The forms on this page are only intended for patients of Ophthalmic Physicians of Monmouth.