Get Optomap Consent Form - Effingham Eye Care

Filling out the Optomap Consent Form is a crucial step in ensuring your understanding and acceptance of the Optomap retinal exam at Effingham Eye Care. This guide will provide you with clear, step-by-step instructions to help you complete the form accurately and confidently.

Follow the steps to complete the Optomap Consent Form effectively.

1. Press the ‘Get Form’ button to access the Optomap Consent Form online and open it in your editing tool.
2. Read the introduction carefully to understand the importance of the Optomap retinal exam. This section provides essential information regarding the procedure and its benefits.
3. Indicate your choice regarding the Optomap retinal exam by marking one of the options provided. Choose 'YES' if you would like to proceed with the exam for a $35 co-pay, 'NOT SURE' if you want to discuss it further with your doctor, or 'NO' if you prefer dilation instead. Ensure you select the option that accurately reflects your decision.
4. For those opting out of both the dilation and the Optomap exam, make sure to select the appropriate option and understand that a comprehensive examination will not be performed.
5. Provide your signature in the designated space, confirming your consent and understanding of the information presented in the form.
6. Enter the date of completion next to your signature to finalize the process.
7. After filling out the form, you can save the changes, download it, print it for your records, or share it as needed.

Complete your Optomap Consent Form online today for a streamlined experience at Effingham Eye Care.