Co Management

Co Management

Co Management

Treehouse Eyes Myopia Treatment Co-Management Form
(Available online at : bit.ly/TreehouseEyesComanage)

Gender

Parent's preferred contact method:

The patient's parent has had their questions answered regarding the c onsquences of treating versus not treating their child's myopia (for example, possible eye health implications of increasing myopia)

Ethnicity

Patient has been myopic for approximately
Years

Parents myopic

Who

Siblings Myopic

VAsc
Current Subj Rx
Previous Rx
Estimated Digital Device Use:
Estimated Time Outdoors:

Will you be co-managing

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