Get Online Diabetes Report Images Form

Filling out the Online Diabetes Report Images Form is a straightforward process that helps ensure accurate documentation of diabetic eye examinations. This guide will walk you through each section of the form to facilitate a smooth completion process.

Follow the steps to fill out the Online Diabetes Report Images Form

1. Press the ‘Get Form’ button to access the form in your preferred document editor.
2. Begin by entering the patient’s name and date of birth in the respective fields.
3. Next, indicate the best corrected visual acuity (BCVA) for both the right and left eyes, recording the visual acuity as specified.
4. Select the appropriate category for diabetic retinopathy for both eyes, choosing from the options provided: No Diabetic Retinopathy, Non-Proliferative Diabetic Retinopathy (NPDR), or Proliferative Diabetic Retinopathy (PDR). Fill in any additional findings or other conditions related to both eyes.
5. If applicable, indicate whether retinal photos were taken for either eye, and provide a referral status if relevant.
6. Finally, write the optometrist's name and the date of the examination, ensuring all information is current and accurate.
7. Once the form is completed, you can save changes, download it, print it, or share it as needed.

Complete the Online Diabetes Report Images Form efficiently and manage your digital documents effectively.