New York Eye and Ear Infirmary
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Filling out forms online using Adobe Acrobat Reader

We are now using the online form filling feature found in Adobe Acrobat PDF (portable document format) files. Because this feature is not widely known or used by computer users on the Internet, we have provided a brief tutorial explaining how to fill out and print the forms found on this page.

Step 1: Open the form

The Admitting Note & Pre-surgical Orders form with fillable fields appearing as yellow shaded areas.Click on the Adobe Acrobat form you wish to use. The form will then load and appear within your browser's window. Note that the fillable fields appear as yellow shaded areas.

(If the form does not load, you may not have the Adobe Acrobat software available on your computer. Click here to download a free copy of the Adobe Acrobat Reader software.

* While you may be able download any PDF form to your computer (by using the disk icon Save a copy icon in Adobe Acrobat to save a copy of the file and use it anytime you wish, we do NOT recommend doing this for Infirmary forms. The newest version of a given form is always posted on this website, and if a particular form you downloaded previously has been subsequently changed, you may find yourself using an outdated form. 

Step 2: Enter Information

Click inside any field in which you wish to enter information. If you place your mouse cursor over a field where information can be typed in, your cursor will change to a vertical line, similar to this: bracket cursor

When the cursor changes to a vertical line, simply click your left mouse key and begin entering the necessary information.

Step 3: About Special Fields

Using your keyboard, enter the information you want to place into the form. Once you have finished entering information in a field, press the Tab button to move the cursor to the next field. 

Please note that there are certain fields with special requirements:

An error produced as a result of not using the correct date format: MM/DD/YYYYDATES (date of birth, day of surgery, date signed, etc.) must be entered using the MM/DD/YYYY format or you may get an error: 

SOCIAL SECURITY NUMBER must be entered using 9 digits (with or without dashes is okay)

PHONE NUMBERS must be entered using only 10 digits

ZIP CODES must be entered using only 5 digits

CheckboxCHECK BOXES: To check (or uncheck) a given box, simply click inside that box area. A check symbol will appear in the box. There may be some instances where you are only allowed to check ONE box in a series (i.e. male/female, inpatient/outpatient, etc.) 

Example of a multi-line fieldMULTI-LINE FIELDS: Some form fields can accommodate larger amounts of text. Press Enter or Return to go to the next line in the same form field. 

Step 4: Proofread Before Printing!

Once you have finished filling out the form, double check all fields to make sure they are accurate. 

Step 5: Print

To print the form, choose File > Print or click on the printer icon Netscape's printer icon Internet Explorer's printer icon in your web browser. If you need to use the form again...  Reset buttonWhen you come back to this page in the future to use the form, you may notice that your fields may contain the old information. Reset the form by clicking on the Reset this Form button, which is usually located at the top right side of the form. This will automatically clear out all of the fields within the form. (You can also use this button at any time if you have made several mistakes and want to start over.)