Thank you for visiting Surgical Services International Opthalmic Consultation Form. We will forward your medical details to your surgeon who will reply with his/her clinical evaluation and any questions he may have for you.
How long have you been considering surgery?
Have you had any opthalmic surgery in the past? If so which procedures have you had and were you happy with the results?
Do you have any questions about the procedure(s)?
List any medications you take including herbal medications :
List all major illnesses or injuries
(diabetes, high blood pressure, emphysema, heart attacks, etc):
(rosacea, skin cancer, psoriasis, etc.)
(MS, stroke, seizures, etc.)