Dr. Austin Ekeoba

Forms library

24 forms · sign-on-screen, fillable, or printable · EN + FR ready

Send before the visit: Claude can detect a patient's chief complaint and auto-suggest the right intake forms, education handouts, and questionnaires to send via SMS or email. Reduces in-office paperwork by ~60%.
consent
EN · FR
Consent — Pupil dilation
Standard consent for pharmacologic dilation. Risks, side effects, post-dilation precautions.
routine
Sign on screen · 1pv.2026-01-15
consent
EN · FR
Consent — OCT / fundus photography
Photography and OCT imaging consent. Includes data storage policy.
imaging
Sign on screen · 1pv.2026-02-08
consent
EN · FR
Consent — Contact lens fitting
CL fitting risks (microbial keratitis, hypoxia, etc.) and care responsibilities.
contact-lens
Sign on screen · 2pv.2025-11-22
consent
EN
Consent — Low vision rehabilitation
Low vision evaluation consent and expectations.
PDF · 2pv.2025-09-01
consent
EN · FR
Authorization — Release of records
PHIPA-compliant release of patient records to external providers / family.
legalphipa
PDF · 1pv.2026-03-04
education
EN · FR
Patient education — Glaucoma
What is glaucoma, types, drop adherence, why it matters.
glaucoma
PDF · 4pv.2026-02-14
education
EN · FR
Patient education — Diabetic retinopathy
How diabetes affects the eye, screening intervals, A1C targets.
diabetes
PDF · 4pv.2026-01-30
education
EN · FR
Patient education — Age-related macular degeneration
Dry vs wet AMD, AREDS2, Amsler grid use.
amdretina
PDF · 4pv.2026-03-12
education
EN · FR
Patient education — Dry eye disease
Tear film basics, lifestyle modifications, treatment ladder.
dry-eye
PDF · 3pv.2025-12-08
education
EN · FR
Patient education — Cataracts
What cataracts are, when to consider surgery, IOL options.
PDF · 4pv.2026-02-26
education
EN
Patient education — Keratoconus
Diagnosis, progression, treatment options including CXL & scleral lenses.
PDF · 3pv.2025-10-19
education
EN · FR
Patient education — Digital eye strain
20-20-20 rule, ergonomics, blue light considerations.
PDF · 2pv.2026-04-01
education
EN · FR
Patient education — Childhood myopia control
Atropine, ortho-K, MiSight — comparing the options for parents.
pediatric
PDF · 4pv.2026-02-02
intake
EN · FR
New patient intake
Demographics, ocular & medical history, medications, family history.
new-patient
Fillable · 4pv.2026-04-10
intake
EN · FR
Medical history update
Quick update form for established patients — meds, allergies, conditions.
Fillable · 1pv.2026-03-22
intake
EN · FR
Lifestyle / vision needs
Occupation, hobbies, screen use, sports, driving — informs Rx and lens advice.
Fillable · 1pv.2026-01-08
questionnaire
EN · FR
OSDI — Dry eye questionnaire
Validated 12-item Ocular Surface Disease Index. Auto-scored.
dry-eyevalidated
Fillable · 1pv.2025-08-04
questionnaire
EN · FR
SPEED — Dry eye questionnaire
Standard Patient Evaluation of Eye Dryness — quick 4-item version.
dry-eye
Fillable · 1pv.2025-08-04
questionnaire
EN
NEI VFQ-25 — Vision quality of life
National Eye Institute 25-item visual function questionnaire.
validated
Fillable · 4pv.2025-06-12
post-op
EN · FR
Post-op instructions — Cataract
Drop schedule, activity restrictions, when to call.
surgery
PDF · 2pv.2026-02-18
post-op
EN · FR
Post-op instructions — YAG capsulotomy
Recovery expectations and warning signs.
PDF · 1pv.2026-01-14
post-op
EN · FR
Post-injection care — Anti-VEGF
Care after intravitreal injection, what to watch for.
injection
PDF · 1pv.2025-12-28
instructions
EN · FR
How to instill eye drops
Step-by-step illustrated guide for proper drop technique.
PDF · 1pv.2025-11-08
instructions
EN · FR
Contact lens care & hygiene
Cleaning, storage, replacement schedule, safe wear.
contact-lens
PDF · 2pv.2026-01-22