Board-Certified Ophthalmologist
Phone 503.581.5287
Fax 503.386.1377
I,
, understand that, due to my autoimmune disorder,
Patient Name
there is an increased risk in performing the iLASIK surgery. However, the FDA has completed testing which
conclusively finds that iLASIK can be performed effectively and safely in selected patients with stable and
controlled systemic diseases.
I understand the above statement and willingly proceed with iLASIK.
