LASIK Consultation Form
What a LASIK consultation form asks, with sample questions on vision goals, glasses, contact lenses, and health.
A LASIK consultation form records why the patient wants vision correction, glasses and contact lens history, and eye and general health before a LASIK consultation. The questions on this page are built from refractive surgery forms of two university eye institutes and an eye practice.
LASIK consultation form, handled by the AI Doctor avatar
AI Doctor, a real-time AI healthcare assistant avatar, asks the questions on a LASIK consultation form in the patient's own language, strictly following the practice's instructions.
- Intake before the visit. Patients answer online before they arrive, or at a kiosk when they check in.
- Answers ready for the clinician. Clinicians see what the patient said before the visit starts.
- Less workload at the front desk. Staff spend less time handing out forms and entering answers by hand.
- Key details at a glance. The care team sees what matters up front and decides who needs attention first.
The form becomes a natural conversation: patients answer by talking, in their own words. AI Doctor is an information and patient-assistance interface. It collects answers for the care team to review. It doesn't diagnose, triage, or give treatment advice.
Sample LASIK consultation form questions
Typical questions, written out so you can see the level of detail. Every practice words its own form differently.
- Why are you interested in vision correction?Goals
- Which procedure are you interested in?Goals
- How long have you worn glasses?Glasses
- Has your prescription been changing regularly?Glasses
- What type of contact lenses do you wear?Contact lenses
- When did you last wear your contacts?Contact lenses
- Have you had any eye surgery or injury?Eye history
- Has anyone in your family had keratoconus?Eye history
- Do you have diabetes or an autoimmune disease?Medical history
- Are you pregnant or nursing?Medical history
- Which medicines do you take, and at what dose?Medicines
- Do you use artificial tears, and how often?Medicines
These are examples to read, not a form to fill in.
LASIK consultation form: FAQ
What does a LASIK consultation form ask?
The sample questions here are based on forms from the University of Rochester Flaum Eye Institute, UCLA Jules Stein Eye Institute, and an eye practice. This page groups them into six areas: goals, glasses, contact lenses, eye history, medical history, and medicines.
Who fills in a LASIK consultation form, and when?
The patient, before the consultation. The UCLA Jules Stein Eye Institute questionnaire asks to be completed before the appointment.
Does it ask about contact lens wear?
Yes. The Flaum Eye Institute form asks the lens type and when the patient last wore contacts.
Does the form cover other vision correction procedures?
It can. An eye practice's refractive evaluation form asks which procedure the patient is interested in and about past RK, PRK, or LASIK.
Is there a LASIK consultation form template?
The sample questions on this page show a typical set.
What happens after the form is completed?
The refractive surgery team reviews the answers at the consultation. AI Doctor only collects them; it does not judge whether a patient can have LASIK.
Does AI Doctor give medical advice?
No. It collects information for the care team. It doesn't diagnose, triage, or recommend treatment.
Can patient answers stay on our own servers?
Yes. RAVATAR offers on-prem deployment: the platform can run inside your own perimeter, so patient answers stay there. RAVATAR complies with GDPR and the EU AI Act.
Set up your AI Doctor in Genesis AI Avatar Studio
Genesis AI Avatar Studio is where you set up, test, and publish AI avatars for your website, mobile app, or Holobox. No coding or technical skills needed.
- 01Choose the AI Doctor avatar.
- 02Add your practice's FAQs and visit information.
- 03Talk to it, then publish it.
