Nurse Form Operative Report For:Pre-Op Diagnosis: RIGHT LEFT BILATERAL Surgeon:Date Of Surgery: MM slash DD slash YYYY Procedure(s): RIGHT LEFT BILATERAL Flap Method: FS Laser Keratome Laser/RF: WaveLight Bausch and Lomb Carl Zeiss Meds:(i.e. Valium 5mg and Meperzine one tablet)Pre-op drops: Ciprofloxicin Naphcon A Acular Post-op drops: Ciprofloxicin Acular Prednisolone Acetate Referring Doctor:Create Referring Doctor Letter? Yes CAPTCHA
