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.

TitleTopic
ABN – BlepharoplastyABN
ABN – CanaloplastyABN
ABN – Corneal TopographyABN
ABN – GlassesGlasses
ABN – Glasses No DMERCGlasses
ABN – Glasses Non-PARGlasses
ABN – Refractive Cataract Surgery ASCABN
ABN – Refractive Cataract Surgery Pretesting (Surgeon)ABN
ABN – Refractive Cataract Surgery Professional Fee (Surgeon)ABN
ABN – YAG FloaterABN
ABN (Advance Beneficiary Notice of Noncoverage)ABN
ABN Guidelines Applicable to an Optical DispensaryGlasses
ASC Disclosure of Physician OwnershipASC
Cataract & Refractive Lens Exchange QuestionnairePretreatment Questionnaire
Co-Management Consent FormCo-Management
Co-Management Request FormCo-Management
Co-Management Request Form with Sample Transfer AgreementsCo-Management
Compliance Incidence Conduct ReportCompliance
Consultation Request FormConsultation
Exam FormExam
Exam Form for OculoplasticsExam
Exam Form for Oculoplastics (Short)Exam
Exam Form for Pediatric UseExam
Extended Ophthalmoscopy FormTest Interpretation
Financial Hardship FormFinancial Hardship Form
Fundus Photography with RHA FormsFundus Photography
Glasses Delivery ReceiptGlasses
Glasses Rx FormGlasses
Glasses Signature on File FormGlasses
Glasses Supplier Standards for DMEPOSGlasses
Glasses Supplier Standards for DMEPOS (Short)Glasses
HCPCS Codes for Vision CareGlasses
History of Present Illness FormHPI
IMT Informed Decision AgreementImplantable Miniature Telescope
Laser Floater Forms (Ellex)Laser Floaters
Laser Operative ReportOperative Report
Medical History FormMedical History
Medicare Overpayment LetterMedicare Overpayment
Medicare Overpayment Self-Disclosure LetterMedicare Overpayment
Minor Procedure Operative ReportOperative Report
Minor Procedure Operative Report – OptometryOperative Report
NEHB – Deluxe IOLNEHB
NEHB – PRKNEHB
NEHB – Pseudophakic MonovisionNEHB
NEHB – Refractive KeratoplastyNEHB
NEHB – Toric IOLNEHB
NEHB (Notice of Exclusion from Health Plan Benefits) – GenericNEHB
Out of Network WaiverOut of Network Waiver
Photography Request FormTest Interpretation
Presurgical Questionnaire – CataractPretreatment Questionnaire
Presurgical Questionnaire – Eyelid and BrowPretreatment Questionnaire
Presurgical Questionnaire – YAGPretreatment Questionnaire
Request for Review for Private Insurance FormPrivate Insurance
Rosacea QuestionnairePretreatment Questionnaire
Signature on File / Assignment of Benefits (English)Signature on File
Signature on File / Assignment of Benefits (Spanish)Signature on File
TearLab Dry Eye QuestionnairePretreatment Questionnaire
TearLab Tear Osmolarity Testing Order & Interpretation FormsTest Interpretation
Test Interpretation FormTest Interpretation
Test Interpretation Form – OptometryTest Interpretation
Test Interpretation Form – PachymetryTest Interpretation
Topography Order & Interpretation FormTest Interpretation
VEP Report FormTest Interpretation
Waiver of Insurance FormWaiver of Insurance