Glaucoma Reporting-Information Sharing Form
Please use this form when co-managing Glaucoma patients with SouthEast Eye Specialists. Information such as vision changes, IOP, VFs, and OCTs can be conveyed securely. This is not intended to be used for initial patient consultation.
Patient & Consulting Doctor Information
Glaucoma Information:
If yes, please attach/fax to SEES
If yes, please attach/fax to SEES
Eye Medications
Additional Information
By entering my initials below and submitting this form, I am verifying that the information in this post-op report is accurate and true as of the date of the exam.