Diabetes eye exam report form 2025

1. Click ‘Get Form’ to open the diabetes eye exam report form in the editor.
2. Begin by entering the clinic or office details, including the address, phone, and fax numbers at the top of the form.
3. Fill in the patient's name and date of birth (DOB) in the designated fields.
4. Record visual acuity for both right (R) and left (L) eyes in the respective sections.
5. Input intraocular pressure readings for both eyes as indicated.
6. In the retinal examination findings section, select appropriate options based on your assessment. You can check boxes or write notes as needed.
7. Indicate any cataract or glaucoma conditions and their impact on daily living activities.
8. Outline a plan of treatment, specifying follow-up timelines and referrals if necessary.
9. Have the eye care provider print their name, sign, and date at the bottom of the form before submitting it.

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