Get Patient Information - Updegraff Lasik

Navigating medical documents can often feel overwhelming. This guide is designed to provide you with clear, step-by-step instructions on how to fill out the Patient Information - Updegraff Lasik form online, ensuring that you complete it accurately and efficiently.

Follow the steps to complete the Patient Information - Updegraff Lasik form online:

1. Press the ‘Get Form’ button to obtain the Patient Information - Updegraff Lasik form. This action will allow you to view and edit the document in an online format.
2. Begin by selecting the appropriate title that describes you by circling one of the options: MR, MS, MRS, or MISS. Next, provide your first and last names in the designated fields.
3. Fill in your address, city, state, and zip code. Ensure that all information is current and accurately reflects where you reside.
4. Indicate your sex by marking either 'M' for male or 'F' for female, then proceed to provide your age, date of birth (DOB), and social security number (SS#).
5. Enter your home phone number, business phone number, and cell phone number as applicable. This will facilitate communication with the practice.
6. List your employer and occupation in the provided fields to give context regarding your professional background.
7. Include your email address to enable digital correspondence related to your appointment.
8. Identify who referred you to this practice, and provide the name of your current eye doctor, along with their phone number.
9. Answer whether your current eye doctor has ever suggested LASIK eye surgery to you by marking 'Y' for yes or 'N' for no.
10. Complete the emergency contact section by entering the name, relationship, and phone number of someone to be contacted in case of an emergency.
11. Respond to the series of questions regarding your consideration of LASIK and history by providing thorough answers in the designated spaces.
12. Review and complete the Assignment and Release section, acknowledging your understanding of payment responsibilities and the conditions surrounding your consultation.
13. Submit the form by saving changes, and you may choose to download, print, or share it after checking for accuracy.

Complete your Patient Information - Updegraff Lasik form online today for a seamless experience.