Forms

Also, we require you bring with you the following:

  • Current insurance card
  • Co-payment
  • A list of any medications that you take, including over the counter and prescription drugs
  • All pairs of glasses that you have, with over the counter readers included.
  • Any contact lens prescriptions and/or any packaging or boxing (if you fail to bring your prescription and/or boxes, you will possibly be charged a refit fee in addition to your contact lens exam fee.)

If you do not bring your most current copy of your insurance card, you will be responsible for payment in full at time of service.

Also, we ask that if you have any previous records please send them prior to your appointment by fax to 1-(555)-ETC-Eyes

Affiliates

  • Neighborhood Schools
  • Local Recreation Centers
  • Sports Teams
  • American Optometric Association
  • National Optometric Association

 
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