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Articles and Links
Glossary of Terms
Patient Forms
Referring Medical Professionals
Corporate Vision Program


Patient Forms


General

Benjamin Eye Institute - New Patient FormDownload
PDF, 94KB

Minor Surgical Procedure Consent FormDownload
PDF, 59KB



LASIK

LASIK Consultation Questionnaire
Please take a few minutes to fill out this questionnaire and bring it with you to your consultation.
Download
PDF, 112KB

Informed Intralasik Consent
This information is being provided to you so that you can make an informed decision about IntraLase, or All-Laser LASIK.
Download
PDF, 105KB



Cataracts


Quality Vision Check
This checklist will assist us in providing the treatment best suited for your
visual needs if it is determined that cataract surgery is appropriate for you.
Download
PDF, 103KB

Informed Consent for Cataract Operation and/or Implantation of Intraocular Lens
This information is given to you so that you can make an informed decision about cataract surgery.
Download
PDF, 88KB

Preoperative Testing Guidelines for Cataract Patients
Please print out this form and give it to your primary care physician for your pre-op appointment.
Download
PDF, 62KB



Other Forms

Consent for Use of Botox CosmeticDownload
PDF, 55KB

Informed Consent for Nearvision CK
This information is being provided to you so that you can make an informed decision about the use of a device knows as the ViewPoint CK System, which is utilized to perform the NearVision CK procedure.
Download
PDF, 107KB

Informed Consent for Endoscopic CycloPhotocoagulation (ECP)Download
PDF, 69KB

Confirmation of Informed Consent for Photorefractive Keratectomy (PRK)
This information must be reviewed so you can make an informed decision regarding PRK surgery.
Download
PDF, 83KB

Informed Consent for Punctal OcclusionDownload
PDF, 117KB






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Inside BEI:   About UsWhat's NewPayment OptionsIn The MediaTestimonialsContact Us

Our Services:   LASIKRestoring Vision over 40CataractsGlaucomaDry EyeGeneral Ophthalmology
Optometric ServicesCosmetic ServicesOther Services and Procedures

Additional Information:   Articles and LinksGlossary of TermsPatient FormsReferring Medical Professionals
Corporate Vision Program

Other Links:   Staff Login

Our Address:   9201 Sunset Boulevard, Suite 709, West Hollywood, CA 90069




Copyright © Benjamin Eye Institute, 2007
All rights reserved. Any part of this website may not be copied and used without permission.

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Dr. Arthur Benjamin is a LASIK and Intralase Los Angeles specialist who has helped thousands of patients from the Los Angeles area to obtain better vision.
He is also a Los Angeles cataract surgery specialist who offers the newest technology lenses, including the ReSTOR and Tecnis IOLs.
Please Visit Benjamin Eye Institute at: 9201 Sunset Boulevard, Suite 709, West Hollywood, California 90069
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