Cornea Transplant Patient Checklist

A sample of content in this file:

Cornea Transplant Patient Checklist

The Lions World Vision Institute wristband is yours to wear as a symbol and a reminder that you are about to receive the Gift of Sight. It is important to do your part by completing all necessary items on the checklist below to ensure surgery can be performed on the designated date and time reserved for you.

The corneal tissue you will be receiving is a precious gift from a donor who recently passed away. Donor families are contacted about tissue donation while still grieving their loved one because it is necessary to transplant tissue within a short timeframe. Many donor families hold on to the hope that something good will come out of something so sad and their loved one’s donation will make a difference in someone else’s life.

The cornea requested for the day of surgery is specifically prepared for you; make sure that the tissue isn’t wasted or discarded. Please be prepared to do your part in honor of the donor.

Thank you for doing your part by completing the following tasks:

• _____ Received medical clearance if required
• _____ Consents signed and returned
• _____ Confirmed my insurance has been verified
• _____ Payments/co-pays completed prior to procedure; medical office and/or surgery center
• _____ Arranged transportation to and from surgery and post-op appointment
• _____ Date, time, and surgery location confirmed
• _____ Medication picked up prior to surgery, instructions received
• _____ Please note not to eat or drink after midnight
• _____ I have reviewed my instructions and aware I am about to receive the Gift of Sight

Please contact your surgical coordinator with any questions.