Informed Consent

From this section you can download the informed consent forms to be duly filled in and submitted to the staff of Centro Vista

DATA SHEET AND INFORMED CONSENT FORM FOR AMD genetic testing 6

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DATA SHEET FOR RETINAL ANGIOGRAPHY TEST

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DATA SHEET FOR INTRAOCULAR OR PERIOCULAR ADMINISTRATION OF ANTI-VEGF DRUGS IN THE TREATMENT OF GLAUCOMA

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DATA SHEET FOR CHALAZION REMOVAL SURGERY

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DATA SHEET FOR TREATMENT OF MACULOPATHIES BY INTRAVITREAL ADMINISTRATION OF BEVACIZUMAB (AVASTIN, Roche)

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DATA SHEET FOR BLEPHAROPLASTY SURGERY

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DATA SHEET LASER CAPSULOTOMY SURGERY

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DATA SHEET CATARACT REMOVAL SURGERY

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DATA SHEET LAMELLAR KERATOPLASTY SURGERY

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DATA SHEET FOR PERFORATING KERATOPLASTY (OR CORNEAL TRANSPLANTATION)

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DATA SHEET FOR CORNEAL REFRACTIVE SURGERY WITH LASER

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DATA SHEET FOR COMBINED CATARACT AND GLAUCOMA SURGERY

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DATA SHEET FOR CRYOTHERAPY

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DATA SHEET FOR UV-A CORNEAL CROSS-LINKING

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DATA SHEET FOR EXTERNAL DACRYOCYSTORHINOSTOMY SURGERY

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DATA SHEET FOR DALK SURGERY (Deep Anterior Lamellar Keratoplasty)

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DATA SHEET FOR RETINAL DETACHMENT SURGERY and CHOROIDAL MELANOMA RESECTION

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DATA SHEET RETINAL DETACHMENT SURGERY

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DATA SHEET AND INFORMED CONSENT TO ECTROPION REPAIR SURGERY

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DATA SHEET AND INFORMED CONSENT TO ENTROPION REPAIR SURGERY

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DATA SHEET FOR ENUCLEATION FOR RETINOBLASTOMA

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DATA SHEET FOR ENUCLEATION SURGERY

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DATA SHEET FOR EXAMINATION OF THE CHILD UNDER GENERAL ANAESTHESIA

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DATA SHEET REFRACTION TEST IN THE CHILD

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DATA SHEET FOR EVISCERATION SURGERY

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DATA SHEET FOR TREATMENT OF MACULOPATIES BY INTRAVITREAL ADMINISTRATION OF AFLIBERCEPT (EYLEA, Bayer)

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DATA SHEET FOR MACULAR HOLE REPAIR VITRECTOMY SURGERY

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INFORMATION NOTE FOR GLAUCOMA SURGERY

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DATA SHEET SURGICAL INTERVENTION OF INTRAOCULAR LENS IMPLANTATION IN PHAKIC EYE

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DATA SHEET FOR CONTACT LENS IMPLANTATION

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DATA SHEET FOR SECONDARY ORBITAL IMPLANTATION SURGERY

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SDATA SHEET CYCLOBLATION SURGERY

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DATA SHEET FOR CONJUNCTIVAL DACRYOCYSTORHINOSTOMY SURGERY

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DATA SHEET IRIDOTOMY SURGERY / LASER IRIDOPLASTY

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DATA SHEET RETINAL LASER SURGERY

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DATA SHEET FOR TREATMENT OF MACULOPATIES BY INTRAVITREAL ADMINISTRATION OF RANIBIZUMAB (LUCENTIS, Novartis)

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DATA SHEET FOR VITRECTOMY SURGERY FOR DISLOCATION INTO THE VITREOUS CHAMBER OF NUCLEAR FRAGMENTS OF THE CRYSTALLINE LENS/IOL

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DATA SHEET FOR TREATMENT OF MACULOPATIES BY INTRAVITREAL ADMINISTRATION OF PEGAPTANIB (MACUGEN, Pfizer)

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DATA SHEET FOR NEEDLING

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DATA SHEET FOR RADIAL OPTIC NEUROTOMY SURGERY FOR CENTRAL RETINAL VEIN OCCLUSION

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DATA SHEET FOR INTRAVITREAL ADMINISTRATION OF OCRIPLASMIN (JETREA)

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DATA SHEET FOR TREATMENT OF MACULAR EDEMA BY INTRAVITREAL IMPLANT OF SUSTAINED-RELEASE DEXAMETHASONE 0.7 MG (OZURDEX®, ALLERGAN)

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DATA SHEET FOR TREATMENT OF PNEUMO-TRABECULOPLASTY (PNT)

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DATA SHEET FOR PTERYGIUM REMOVAL SURGERY

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DATA SHEET FOR PTK SURGERY OR PHOTOTHERAPEUTIC KERATECTOMY WITH EXCIMER LASER

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DATA SHEET FOR EYELID PTOSIS CORRECTION SURGERY

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DATA SHEET FOR PREMACULAR MEMBRANE VITRECTOMY SURGERY

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DATA SHEET FOR PATIENT’S GENETIC RESEARCH

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DATA SHEET FOR REMOVAL AND/OR SECTION CERCLAGE AND/OR BUCKLING

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DATA SHEET FOR TREATMENT OF STRABISMUS

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DATA SHEET FOR TREATMENT OF MACULOPATIES BY INTRAVITREAL ADMINISTRATION OF TRIAMCINOLONE ACETONIDE (TAIOFTAL®, SOOFT S.p.A.)

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DATA SHEET FOR SURGICAL IMPLANT OF TANTALIUM CLIPS IN OCULAR MELANOMA

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DATA SHEET FOR LASER TRABECULOPLASTY SURGERY

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DATA SHEET FOR ENDOTHELIUM TRANSPLANT SURGERY (EK)

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SDATA SHEET FOR TREATMENT WITH RESTASIS® 0.05%

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DATA SHEET FOR USE OF ANTIFIBROTIC DRUGS IN INTRA- AND POST-OPERATIVE TREATMENT OF GLAUCOMA

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DATA SHEET FOR VITRECTOMY FOR ABLATION OF NEW SUBRETINAL VESSELS

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DATA SHEET FOR VITRECTOMY SURGERY FOR DIABETIC RETINOPATHY

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DATA SHEET FOR VITRECTOMY SURGERY FOR REMOVAL OF SUBRETINAL NEOVASCULAR MEMBRANES

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DATA SHEET FOR VITRECTOMY SURGERY FOR PROLIFERATIVE VITREORETINOPATHY

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DATA SHEET FOR VITRECTOMY SURGERY FOR VITREOUS HAEMORRHAGE/ASTEROID HYALOSIS /SYNCHYSIS SCINTILLANS/ PERSISTENT HYPERPLASTIC PRIMARY VITREOUS

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