St. Luke's Cataract & Laser Institute

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    • Careers
    • Our Physicians & Staff
    • Patient Forms
    • Chaplain Services
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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

Medical History

Patient Statement of Rights and Responsibilities

Notification Regarding Patient Rights

Surgery Center Patient Information Card & Map

Lifestyle-Questionnaire

Hearing-Services-Questionnaire

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

St. Luke's Cataract & Laser Institute
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Our Locations
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