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Chart Forms


Vision Preferences Checklist
Vision Preferences Checklist

Determine a patient’s emotional suitability for upgraded LENS implants before the consultation begins.

Vision Preferences ChecklistMore Details
One of the most difficult challenges is assessing candidacy for upgraded IOLs. All elective vision procedures must include a thorough assessment of the patient's personality fit and psychological adaptability, because this is where you uncover unreasonable expectations. Give the patient the opportunity to consider the vision they want before the exam by mailing this questionnaire in advance. Remember, they've never been asked what type of vision they prefer, and if they had to wear glasses, when would it be OK. You need to know.

Fully editable. 1 page. Available for immediate download. Customize with your practice logo.


Price: $10.00
Cataract Evaluation
Cataract Evaluation

This dilated exam form provides all necessary fields for appropriate charting and coding of insurance procedures. In addition, it provides prompts and checkboxes for staff to ensure all testing and education have been completed prior to the surgeon's exam.

Cataract EvaluationMore Details
Fully editable. 1 page. Available for immediate download. Customize with your practice logo.


Price: $29.00