Please Send to Patient Form

If you receive a “Please Send to Patient” form, this is a list of the patient education, forms, and/or agreements that need to be emailed to the patient.

In the form, the patients name and email will be listed.

Compose a new email to this patient, and copy and paste the following message in the email:

Dear (patient name), it was so great to see you at your eye appointment today! We hope you enjoyed your experience at our new Lewis Center location, and that all of your eye care needs were met above your expectations! As promised, we have attached the information you or your doctor requested. Please let us know if you have any questions on the materials attached, and we look forward to seeing you again soon! Have an excellent day!

Then, click on the paperclip icon to attach the files indicated on the form. All of the files will be in the “Lewis Center” folder, located in the “PR Tracking Spreadsheets” folder.

Once all the files have been attached, send the email.

Next, we need to upload the form into the patient’s Scanned Documents. To do this:

Open the pdf attachment in the email.

Click on “Edit”

Select “Copy to Clipboard”

Go into the patient’s demographic in Eyecare, and click on the Scanned Documents icon

Click on “Import,” then “Clipboard.”

For “Type,” select “Patient Letter,” and in “Name,” type “Forms Sent to Pt.”

Save in Eyecare, then delete the email.

Fax Cover Sheet

If a fax cover sheet is sent to you, then it is a request from LC to fax information to another doc/practice/etc.

Please review the information, and fax the appropriate information, then follow the instructions below to import the document in the patient's scanned documents section in eyecare. 

Open the pdf attachment in the email.

Click on “Edit”

Select “Copy to Clipboard”

Go into the patient’s demographic in Eyecare, and click on the Scanned Documents icon

Click on “Import,” then “Clipboard.”

For “Type,” select “Ref Letter,” and in “Name,” type a brief description of the fax.

Save in Eyecare, then delete the email.

Records Release Form

If a Records Release  form is sent, you will need to print/send the records as described in the form, and then this document needs to be uploaded into the patient’s Scanned Documents in Eyecare. To do this:

Follow the instructions in the records release, and print/email/fax the requested records to the indicated parties.

Open the pdf attachment in the email.

Click on “Edit”

Select “Copy to Clipboard”

Go into the patient’s demographic in Eyecare, and click on the Scanned Documents icon

Click on “Import,” then “Clipboard.”

For “Type,” select “Records Release,” and in “Name,” type where you are sending the records.

Save in Eyecare, then delete the email.

Diabetic Report

If a Diabetic Report is received, you will need to import this into the patients scanned documents AND print/mail the report to the designated doctor on the report. To do this:

Open the pdf attachment in the email.

Click on “Edit”

Select “Copy to Clipboard”

Go into the patient’s demographic in Eyecare, and click on the Scanned Documents icon

Click on “Import,” then “Clipboard.”

For “Type,” select “Diabetic Report,” and in “Name,” type the doctor you are sending the report to (as indicated on the Diabetic Report).

Save in Eyecare.

Then, print off the form to send to the doctor listed in the report. You can Google the provider and fax, call and email, or mail to the provider. THIS STEP MUST BE DONE before you delete the email.

If you cannot find the provider, send a todo to the OA, asking for the information.

Once the Diabetic Report is sent to the provider, you may delete the email.

HIPAA Form

If any HIPAA form is sent, the patient has requested that we email them a copy of our Notice of Privacy Practices (found in the Lewis Center folder).

Please send an email to the patient with the following script:

Dear (patient name),

As requested, we have attached a copy of Professional VisionCare’s Notice of Privacy Practices. If you have any questions regarding how we safeguard your protected health information, please let us know! Thanks, and have a wonderful day!

Attach the NPP document, and send!

Next, please upload the form you received into the patient’s Scanned Documents in Eyecare. To do this,

Open the pdf attachment in the email.

Click on “Edit”

Select “Copy to Clipboard”

Go into the patient’s demographic in Eyecare, and click on the Scanned Documents icon

Click on “Import,” then “Clipboard.”

For “Type,” select “HIPAA,” and in “Name,” type the date.

Save in Eyecare, then delete the email.

3rd Party ABN, Medicare ABN, and Medicaid ABN

If any ABN form is sent, this document needs to be uploaded into the patient’s Scanned Documents in Eyecare. To do this:

Open the pdf attachment in the email.

Click on “Edit”

Select “Copy to Clipboard”

Go into the patient’s demographic in Eyecare, and click on the Scanned Documents icon

Click on “Import,” then “Clipboard.”

For “Type,” select “ABN,” and in “Name,” type the type of ABN and date.

Save in Eyecare, then delete the email.

Frame Waiver

If a Frame Waiver  form is sent, this document needs to be uploaded into the patient’s Scanned Documents in Eyecare. To do this:

Open the pdf attachment in the email.

Click on “Edit”

Select “Copy to Clipboard”

Go into the patient’s demographic in Eyecare, and click on the Scanned Documents icon

Click on “Import,” then “Clipboard.”

For “Type,” select “PVC Letter,” and in “Name,” type “Frame Waiver.”

Save in Eyecare, then delete the email.

Dilation Waiver Form

If a Dilation Waiver form is sent, this document needs to be uploaded into the patient’s Scanned Documents in Eyecare. To do this:

Open the pdf attachment in the email.

Click on “Edit”

Select “Copy to Clipboard”

Go into the patient’s demographic in Eyecare, and click on the Scanned Documents icon

Click on “Import,” then “Clipboard.”

For “Type,” select “PVC Letter,” and in “Name,” type “Dilation Waiver Form.”

Save in Eyecare, then delete the email.

Contact Lens Care and Handling

If a Contact Lens Care and Handling form is sent, it is the documentation we need to keep notating that the patient received our Contact Lens Care and Handling instructions and their signature will be on the form. This form needs to be uploaded into their Scanned Documents in Eyecare. To do this:

Open the pdf attachment in the email.

Click on “Edit”

Select “Copy to Clipboard”

Go into the patient’s demographic in Eyecare, and click on the Scanned Documents icon

Click on “Import,” then “Clipboard.”

For “Type,” select “Contact Lens Education,” and in “Name,” type “Patient Agreement.”

Save in Eyecare, then delete the email.

Social Media Consent Form

If a Social Media Consent form is sent, this document needs to be uploaded into the patient’s Scanned Documents in Eyecare. To do this:

Open the pdf attachment in the email.

Click on “Edit”

Select “Copy to Clipboard”

Go into the patient’s demographic in Eyecare, and click on the Scanned Documents icon

Click on “Import,” then “Clipboard.”

For “Type,” select “PVC letter,” and in “Name,” type “Social Media Consent Form.”

Save in Eyecare, then delete the email.

School/Work Excuse

If a School/Work Excuse  form is sent, please upload this document in the patient’s scanned documents. To do this:  

Open the pdf attachment in the email.

Click on “Edit”

Select “Copy to Clipboard”

Go into the patient’s demographic in Eyecare, and click on the Scanned Documents icon

Click on “Import,” then “Clipboard.”

For “Type,” select “PVC Letter,” and in “Name,” type “School/Work Excuse.”

Save in Eyecare, then delete the email.

Minor’s Release Form

If a Minor’s Release  form is sent, this document needs to be uploaded into the patient’s Scanned Documents in Eyecare. To do this:

Open the pdf attachment in the email.

Click on “Edit”

Select “Copy to Clipboard”

Go into the patient’s demographic in Eyecare, and click on the Scanned Documents icon

Click on “Import,” then “Clipboard.”

For “Type,” select “Patient Letter,” and in “Name,” type “Minor’s Release Form.”

Save in Eyecare, then delete the email.

CRT Service Agreement Form

If a CRT Service Agreement form is sent, this document needs to be uploaded into the patient’s Scanned Documents in Eyecare. This is a TWO page document, so two pages will need to  be added. To do this:

Open the pdf attachment in the email.

On the first page, Click on “Edit”

Select “Copy to Clipboard”

Go into the patient’s demographic in Eyecare, and click on the Scanned Documents icon

Click on “Import,” then “Clipboard.”

For “Type,” select “Contact Lens Care Education,” and in “Name,” type “CRT Agreement Page One.”

Then, go to the second page in the PDF document and repeat the steps above (starting with going to “Edit,” “Copy to Clipboard,” etc.

Name this second page “CRT Agreement Page Two.”

Save in Eyecare, then delete the email.

Vita Risk Results Form

If you receive a VitaRisk form, this document needs to be uploaded into the patient’s Scanned Documents in Eyecare. To do this:

Open the pdf attachment in the email.

Click on “Edit”

Select “Copy to Clipboard”

Go into the patient’s demographic in Eyecare, and click on the Scanned Documents icon

Click on “Import,” then “Clipboard.”

For “Type,” select “CL Invoice,” and in “Name,” type “Contact Lens Order Form.”

Save in Eyecare, then delete the email.

Contact Lens Order Form

If a Contact Lens order form is sent, this document needs to be uploaded into the patient’s Scanned Documents in Eyecare. To do this:

Open the pdf attachment in the email.

Click on “Edit”

Select “Copy to Clipboard”

Go into the patient’s demographic in Eyecare, and click on the Scanned Documents icon

Click on “Import,” then “Clipboard.”

For “Type,” select “CL Invoice,” and in “Name,” type “Contact Lens Order Form.”

Save in Eyecare, then delete the email.

Medication Form

If a Medication Form is sent, this document needs to be uploaded into the patient’s Scanned Documents in Eyecare. To do this:

Open the pdf attachment in the email.

Click on “Edit”

Select “Copy to Clipboard”

Go into the patient’s demographic in Eyecare, and click on the Scanned Documents icon

Click on “Import,” then “Clipboard.”

For “Type,” select “Medications,” and in “Name,” type the list.

Save in Eyecare, then delete the email.

Medical History Form

If a Medical History Form is sent, this document needs to be uploaded into the patient’s Scanned Documents in Eyecare. To do this:

Open the pdf attachment in the email.

Click on “Edit”

Select “Copy to Clipboard”

Go into the patient’s demographic in Eyecare, and click on the Scanned Documents icon

Click on “Import,” then “Clipboard.”

For “Type,” select “Medical Hx,” and in “Name,” type the date.

Save in Eyecare, then delete the email.

Children’s History Form

If a Children’s History  form is sent, this document needs to be uploaded into the patient’s Scanned Documents in Eyecare. To do this:

Open the pdf attachment in the email.

Click on “Edit”

Select “Copy to Clipboard”

Go into the patient’s demographic in Eyecare, and click on the Scanned Documents icon

Click on “Import,” then “Clipboard.”

For “Type,” select “Children’s History,” and in “Name,” type the date.

Save in Eyecare, then delete the email.

Infant History Form

If a Infant History form is sent, this document needs to be uploaded into the patient’s Scanned Documents in Eyecare. To do this:

Open the pdf attachment in the email.

Click on “Edit”

Select “Copy to Clipboard”

Go into the patient’s demographic in Eyecare, and click on the Scanned Documents icon

Click on “Import,” then “Clipboard.”

For “Type,” select “Children’s History,” and in “Name,” type “Infant History Form.”

Save in Eyecare, then delete the email.