Cataract/Lensectomy Pre-Op Form

Use the following form to submit reports on Pre-Op Cataract/Lensectomy procedures. The submitted form will be automatically sent to the Braverman Eye Center. You will also be able to print a copy for your records after submitting the form.

Please complete all applicable form fields:

Co-managing OD/MD:
Patient Name:(last name first)
Age:
Procedure:
Desired Procedure Date:
PRE-OP Rx:
OD: VA: 20/
OS: VA: 20/
OD Intended Procedure Outcome: (leave blank if none)
OD AIM
OS Intended Procedure Outcome: (leave blank if none)
OS AIM
Medications:
Patient/Doctors Comments:
Leave this field blank:

The surgeons of Braverman Eye Center are well known as South Florida, Ft. Lauderdale and LASIK Miami specialists. These renowned surgeons have also helped many Ft. Lauderdale and Miami cataract surgery patients enhance their vision. When you think of Miami cataracts or Miami LASIK, think of Braverman Eye Center.

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