Access Clinical Forms For Your Eye Care Patients

Medical Form Downloads for External Care Providers

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Laser Pre & Postoperative Care Forms

LASIK Interest Form
For your patients that are interested in LASIK – use this form for correspondence.
Pre-Procedure Patient Evaluation for Laser Refractive Surgery
This form is used for evaluating LASIK patients and will be reviewed by SEI Surgeon prior to surgery.
LASIK Patient Data
LASIK patients’ demographics and health history
Patient Authorization for Viewing
Gives permission for family members or friends to view the procedure on surgery day from the viewing area.
Post LASIK Doctor Guidelines
Outlines doctor guidelines for LASIK follow-up care
Post Operative Laser Vision Correction Form
Updated LASIK Instructions 12.28.2024
Updated PRK Instructions 12.28.2024

LASIK Informed Consent Forms

LASIK Informed Consent Form
Form for patient to review prior to LASIK / PRK surgery outlining procedure, follow-up, expectations and risks
SEI Refractive Surgery Co-Management Consent 2023
LASIK 2023 Co-Management Structure Change Letter

Cataract Postoperative Reporting Forms

Cataract Postoperative Reporting Form
Evaluation form for optometrist to complete at cataract surgery post-op exam

Administrative Forms

LASIK Interest Form
For your patients that are interested in LASIK – use this form for correspondence.
Change Form
Use this form to report new locations, doctors, or any changes in practice contact information.
SEI Management Services Agreement
This form is an agreement for collecting the comanagement fee on the affiliate doctors behalf.
Post-Operative Drop Regimen by Surgeon
This form lists the pre and post drop regimen for Cataract and LASIK procedures by surgeon.
Surgeon List for OH and MI
This sheet will show all the surgeons and what areas they specialize in.