Loading
Get Communication Care Form
How it works
-
Open form follow the instructions
-
Easily sign the form with your finger
-
Send filled & signed form or save
How to fill out the Communication Care Form online
Filling out the Communication Care Form is essential for documenting dilated eye exam results accurately. This guide provides you with detailed, step-by-step instructions to help you complete the form online with ease.
Follow the steps to complete the Communication Care Form online.
- Press the ‘Get Form’ button to access the Communication Care Form and open it in your preferred document editor.
- Begin with the patient section. Fill out your name, date of birth, and phone number accurately. After the yearly dilated eye exam, ensure that this form or a copy is sent back to your Primary Care Provider.
- Proceed to the Primary Care Provider section. Enter the names, clinic or office details, and contact information for both the Primary Care Provider and the Eye Care Specialist.
- In the Eye Care Specialists section, provide the date of the eye exam and indicate whether the eyes were dilated for this exam by selecting 'Yes' or 'No'.
- Document the retinal examination findings by checking the appropriate boxes that apply to the eye examination results and note whether a report has been sent to the patient’s Primary Care Provider.
- Specify follow-up eye exam recommendations by selecting from the options provided, and if needed, note any other recommendations.
- At the end of the form, include the Eye Care Specialist’s signature and NPI number to validate the document.
- Once all fields are completed, save the changes to the form. You can also download it for your records, print it, or share it as needed.
Complete your Communication Care Form online today to ensure all necessary records are accurately documented.
Related links form
Once your eyes are dilated, there is an increase in light sensitivity because the pupil is large and more light is coming through, so bring your sunglasses, or your ophthalmologist may provide some disposable shades for your use. You may also experience blurry vision, particularly if you are trying to read.
Industry-leading security and compliance
US Legal Forms protects your data by complying with industry-specific security standards.
-
In businnes since 199725+ years providing professional legal documents.
-
Accredited businessGuarantees that a business meets BBB accreditation standards in the US and Canada.
-
Secured by BraintreeValidated Level 1 PCI DSS compliant payment gateway that accepts most major credit and debit card brands from across the globe.