Get Wpafb Warfighter Laser Surgery Center Patient Information: Full Name: Date: Rank / Grade: Ssn: Dob

Filling out the WPAFB Warfighter Laser Surgery Center Patient Information form is an important step in your surgical journey. This guide is designed to assist you in completing the form accurately and efficiently, ensuring all relevant information is provided online.

Follow the steps to accurately complete your patient information form.

1. To begin, press the ‘Get Form’ button to obtain the form and open it in your browser.
2. In the 'Full Name' field, enter your complete legal name as it appears on your official documents.
3. Fill in the 'Date' field with the current date when you are completing the form.
4. Indicate your 'Rank / Grade' in the appropriate field. This can include designations such as Captain, Major, etc.
5. Include your Social Security Number (SSN) carefully in the designated section.
6. Provide your 'Date of Birth' (DOB) using the format MM/DD/YYYY.
7. Indicate your age in the 'Age' section.
8. Select your branch of service from the options listed: USAF, USA, USN, USMC, or Other.
9. Fill in the 'Date of separation/retirement/ID expiration' field with the relevant date.
10. Choose your sex by circling M (Male) or F (Female) as applicable.
11. Enter your job title in the appropriate section provided.
12. If applicable, circle any relevant designations such as PRP, Aviation, Special Duty, or indicate NA.
13. Complete your home location by entering your address, city, state, and zip code. Also, provide your home and cell phone numbers, as well as your email address.
14. In the medical information section, repeat the steps for your duty location, providing similar information about your current base of operations.
15. Detail any drug allergies or sensitivities, current medications, medical history, and surgical history in the corresponding fields.
16. Circle all applicable medical conditions as instructed on the form.
17. If certain medications apply to you, indicate if you have used them and provide the last date used.
18. Answer any remaining questions about your hobbies, visual requirements, and expectations from refractive surgery.
19. Indicate if you are or have been wearing contact lenses and provide the last date they were used.
20. Select your surgical preference by circling PRK, LASIK, or No Preference.
21. Finally, sign the form in the 'Patient’s Signature' section, ensuring the date is recorded.
22. Upon completing the form, review all entries for accuracy before finalizing.
23. Save your changes, and consider downloading, printing, or sharing the completed form as necessary.

Complete your documents online today for efficient processing at the WPAFB Warfighter Laser Surgery Center.