Forms

Corcoran Consulting Group offers an expansive collection of forms, which can be easily downloaded and/or modified as needed.

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

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

Forms

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