At Tulsa Vision Clinic, we value your time. In an effort to save you time in our office, you can download and complete our patient form(s) prior to your appointment.
- You will need AdobeReader® to download and complete the forms. Click here to download.
- Download the required form(s). Print out the form(s) and complete the required information.
- Fax to (918) 743-6369 your printed and completed form(s) to our office or bring them with you to your appointment.
- Email completed forms to [email protected]
FOLLOWING NEW PATIENT FORMS ARE REQUIRED:
1. New Patient Registration Form
2. Patient History Form
3. HIPPA From
4. Retinal Image Consent Form
Please complete these forms as it lets us know the history and current state of your health. Let us know what questions, concerns, and goals your have regarding your eye health or vision on the form.
New Patient Forms: Download & Print Form
FOLLOWING OPTILIGHT IPL FORMS ARE REQUIRED:
1. Skin Typing Form
2. OPTilight IPL Consent Form
OPTilight IPL Forms:
Fitzpatrick Skin Typing Assessment Quiz
Consent form for OPTilight TVC
INTENSE PULSED LIGHT (IPL) PRE-POST CARE INSTRUCTION:
BEFORE YOUR IPL TREATMENT:
1. NO TANNING 2 WEEKS PRIOR. The area that will be treated with IPL should not have had any sunburn or suntan on the skin for at least 2 weeks prior to treatment. You will need to avoid a suntan on this area for 2 weeks post-treatment. If using a self-tanning product, please wait until it has completely faded.
2. NO RETIN-A 1 WEEK PRIOR. Avoid any irritants to your skin, such as any products containing Retin-A, retinol, benzoyl peroxide, glycolic/salicylic acids, for one week before your treatment.
3. NO WAXING 1 WEEK PRIOR.; SHAVE BEFORE APPOINTMENT. Do not wax or use a depilatory on treatment areas for one week prior to your treatment.
4. NO DOXYCYCLINE. Before each treatment, please inform us if you are taking any new antibiotics or medications as they may make your skin photosensitive and therefore, we may not be able to treat you for two weeks after you complete the medication.
5. HISTORY OF COLD SORES? Please inform our staff if you have a history of cold sores.
AFTER YOUR IPL TREATMENT:
1. Following treatment your skin may feel like it has a slight sunburn. You may experience erythema (redness), edema (swelling), and some discomfort of the treated areas for several hours or up to 3 days post-treatment.
2. You may experience some purpura (purplish spots or patches) in treated areas, which would be expected to resolve within several days.
3. If you experience itching after treatment, you may use over the counter topical hydrocortisone cream. After treatment, your skin may appear slightly reddened which subsides rather quickly. Mild swelling may occur.
4. You may use cold or ice packs, 10-minute intervals, as needed for comfort and to relieve swelling in the ﬁrst 24 hours will help minimize the swelling.
5. Apply mineral sunscreen immediately after treatment. Use a mild cleanser (such as Cetephil, Aquinil, or Dove) and a mild moisturizer after the treatment for a few days before resuming your normal skin routine.
6. Avoid any irritants to your skin, such as any products containing Retin-A, retinol, benzoyl peroxide, glycolic & salicylic acids, astringents or Vitamin C for one week after your treatment.
7. Avoid sun exposure to the treated area for 2 weeks following the treatment (if not indeﬁnitely). Always use a broad spectrum of sunblock of at least 30 SPF or higher.
8. If desired, you may use makeup on the treated area, if the skin is not broken, blistered, or irritated. If you do not need makeup for the evening or treatment, wait until the next morning.
9. Avoid hot baths or showers, aerobic exercise, hot yoga, massage, harsh cleansers, or chemicals on the treated area for 48 hours following treatment.
10. Do not wax, tweeze or use a depilatory to the treated areas for 1 week after your treatment.