Forms

Corcoran Consulting Group has a selection of forms that are free to download and use.

Search for a form topic, or choose a form from our library below.

Topic Title
ABN ABN (Advance Beneficiary Notice of Noncoverage)
ABN ABN – Blepharoplasty
ABN ABN – Canaloplasty
ABN ABN – Corneal Topography
ABN ABN – Refractive Cataract Surgery ASC
ABN ABN – Refractive Cataract Surgery Pretesting (Surgeon)
ABN ABN – Refractive Cataract Surgery Professional Fee (Surgeon)
ASC ASC Diclosure of Physician Ownership
Comanagement Comanagement Consent Form
Comanagement Comanagement Request Form
Comanagement Comanagement Request Form + Sample Transfer Agreements
Compliance Compliance Incidence Conduct Report
Consultation Consultation Request Form
Exam Exam Form
Exam Exam Form – Oculoplastics
Exam Exam Form – Oculoplastics (short)
Exam Exam Form – Pediatric
Financial Hardship Financial Hardship Form
Fundus Photography Fundus Photography with RHA Forms
Glasses ABN – Glasses
Glasses ABN – Non PAR
Glasses ABN – No DMERC
Glasses ABN Guidelines Applicable to an Optical Dispensary
Glasses Glasses Delivery Receipt
Glasses Glasses Rx Form
Glasses Glasses Signature on File Form
Glasses Glasses Supplier Standards for DMEPOS
Glasses Glasses Supplier Standards for DMEPOS (short)
Glasses HCPCS Codes for Vision Care
HPI History of Present Illness Form
Implantable Miniature Telescope IMT Informed Decision Agreement
Medical History Medical History Form
Medicare Overpayment Medicare Overpayment Letter
Medicare Overpayment Medicare Overpayment Self-Disclosure Letter
NEHB NEHB (Notice of Exclusion from Health Plan Benefits)
NEHB NEHB – Deluxe IOL
NEHB NEHB – PRK
NEHB NEHB – Pseudophakic Monovision
NEHB NEHB – Refractive Keratoplasty
NEHB NEHB – Toric IOL
Operative Report Laser Operative Report
Operative Report Minor Procedure Operative Report
Operative Report Minor Procedure Operative Report – Optometry
Out of Network Waiver Out of Network Waiver
Postoperative Care Postoperative Care Request Form
Pretreatment Questionnaire Cataract & Refractive Lens Exchange Questionnaire
Pretreatment Questionnaire Presurgical Questionnaire – Cataract
Pretreatment Questionnaire Presurgical Questionnaire – Eyelid and Brow
Pretreatment Questionnaire Presurgical Questionnaire – YAG
Pretreatment Questionnaire Rosacea Questionnaire
Pretreatment Questionnaire TearLab Dry Eye Questionnaire
Private Insurance Request for Review for Private Insurance Form
Signature on File Signature on File / Assignment of Benefits
Signature on File Signature on File / Assignment of Benefits (Spanish)
Test Interpretation Test Interpretation Form
Test Interpretation Extended Ophthalmoscopy Form
Test Interpretation Photography Request Form
Test Interpretation TearLab Tear Osmolarity Testing Order & Interpretation Forms
Test Interpretation Test Interpretation Form – Optometry
Test Interpretation Test Interpretation Form – Pachymetry
Test Interpretation Topography Order & Interpretation Form
Test Interpretation VEP Report Form
Waiver of Insurance Waiver of Insurance Form

 

 

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