LASIK Eye Surgery Consultation Template
Current prescription capture, dry-eye triage, screen-time risk factor, candidacy match.
Free while in beta · No credit card required
About this lasik eye surgery consultation template
For ophthalmology clinics offering LASIK, SMILE, or PRK. Captures the current prescription (sphere, cylinder, axis) so the surgeon knows in advance whether the patient is in laser-correctable range. Dry-eye triage filters poor candidates upfront.
Conversion tips
Capturing prescription numbers on page 1 lets the clinic pre-screen — a -12.00 myope doesn't qualify for LASIK and can be redirected to ICL instead. The dry-eye scale catches the #1 LASIK contraindication early.
Frequently asked questions
Why ask for the prescription numbers?
LASIK works best for myopia between -1.00 and -8.00 with cylinder under -3.00. The form lets your surgeon see in advance whether the patient is in range, ICL territory, or non-surgical.
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Ship your lasik eye surgery consultation in minutes.
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