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DILATED RETINAL EYE EXAM COMMUNICATION FORM This form is to document dilated eye exam results. Place form directly in the member s medical record. Step #1: Patient Patient: Fill out your name, date.

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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.

  1. Press the ‘Get Form’ button to access the Communication Care Form and open it in your preferred document editor.
  2. 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.
  3. 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.
  4. 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'.
  5. 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.
  6. Specify follow-up eye exam recommendations by selecting from the options provided, and if needed, note any other recommendations.
  7. At the end of the form, include the Eye Care Specialist’s signature and NPI number to validate the document.
  8. 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.

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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.

The exam is simple and painless. Your eye doctor will check for vision problems that make it hard to see clearly, like being nearsighted or farsighted. Then your doctor will give you some eye drops to dilate (widen) your pupil and check for eye diseases.

Dilating your pupil lets more light into your eye just like opening a door lets light into a dark room. Dilation helps your eye doctor check for many common eye problems, including diabetic retinopathy, glaucoma, and age-related macular degeneration (AMD).

In determining whether eye dilation is necessary for you, your eye doctor may consider: Your age. The risk of eye diseases increases with age. The National Eye Institute recommends a dilated eye exam once every one to two years if you're 60 or older.

The dilating drops that we typically use last, on average, 4-6 hours before they wear off. Occasionally, we use longer lasting eye drops in younger children, which can last approximately 24 hours. Most people do feel comfortable to drive after their pupils have been dilated.

There is no way to reduce your pupil size faster. You might consider taking a nap once you get home to reduce how much light your eyes are exposed to. Since it can be hard to do things like read or see a television screen if your vision is blurry, it is best to avoid these activities until the effects wear off.

Dilation allows an eye doctor to look inside your eyes. Dilating drops widen the pupil (the black part of your eye) so that it doesn't get smaller when your doctor shines a light at it. The widened pupil allows your doctor to use a magnifying lens to look inside your eye and at the back of your eye.

Therefore, they require stronger drugs to dilate the pupils. As a result, a child's eyes may stay dilated for 24 hours or longer. Type of drug: The type of drug that a doctor uses to dilate the pupils will affect how long the eyes remain dilated.

How long do dilating drops last? Dilating eye drops used for examination of the eyes usually last anywhere from 4 to 24 hours. This depends on the strength and type of the drop, and on the individual patient. Dilation can last longer in people with lighter colored eyes, and in some cases, may last longer than 24 hours.

Dilation is often a normal part of an eye exam for people who wear glasses or contacts. But if you're young and your eyes are healthy, you may not need it every time. Your doctor also may be able to use other methods to check your retina without dilating your eyes, but they may not work as well.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232