St. Luke's Cataract & Laser Institute

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Patient Forms

For your convenience, some of our most common patient documents are available online. If you prefer to complete a hard copy, please contact us at 800-282-9905 and we’ll be happy to send what’s needed via U.S. mail.

Cataract Patients

Welcome Letter

Medical History

Patient Statement of Rights and Responsibilities

Hearing-Services-Questionnaire

Cataract Surgery Services Sheet

Planning for your eval form

Summary Patient Bill of Rights and Responsibilities

New and Existing Patients

Medical History

Hearing-Services-Questionnaire

LASIK / Refractive Patients

Medical History

Refractive Evaluation Health History

Lifestyle-Questionnaire

Hearing Patients

Hearing Services New Patient Form

Hearing Services Questionnaire

St. Luke's at The Villages Patients

Medical History – St. Luke’s at The Villages

Patient Statement of Rights and Responsibilities – St. Luke’s at The Villages

Notification Regarding Patient Rights – St. Luke’s at The Villages

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