Physician Forms
To use the Mass. Eye and Ear forms, you will need to have Acrobat Reader, free software for which can be installed by clicking on the acrobat image:
Physician Orders
Audiology Referral Forms
Ophthalmology Forms
Re-order Comprehensive Ophthalmology Service Referral Desk Pads
Affiliated Physician Practice Instructions, Intraocular Lens Policy (Updated May 9, 2006)
Authorization to Insert Prebyopic Lens During Conventional Cataract Surgery
Authorization to Insert Presbyopic Crystalens Lens During Conventional Cataract Surgery
Authorization to Insert Presbyopic Toric Lens During Conventional Cataract Surgery
Payment Agreement for Refractive Surgery with PC-IOL Lens Replacement
Payment Agreement for Refractive Surgery with Clear Lens Replacement
Dr. Sang's Orders
Page updated July 7, 2010
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