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Comprehensive Eye Examination

During your examination the doctor will check for any eyeglass prescription, abnormalities in the visual system, depth perception, and color testing. The exam will also include testing for glaucoma, auto-refraction test, muscle focusing, and ocular diseases such as cataracts.

*This is the standard exam given for an eyeglass prescription*

Contact Lens Fitting and Evaluation (required every year)

The contact lens fitting is a supplemental examination given to contact lens wearers. This test MUST be administered in addition to the Comprehensive Eye Examination in order to update your contact lens prescription. This exam will check for the contact lens prescription, curvature and diameter of the eye, as well as the best suited contact lenses and determine whether your eyes are healthy to wear contacts.

Please note- The Doctor will not be able to determine any change in contact lens prescription without performing this exam.*** No exceptions will be made***

Standard Contact Lens Fitting / Evaluation $ 80 (Distance only-one correction) Premium Contact Lens Fitting / Evaluation $159 (Monovision / Mutifocal / Toric)

** In accordance with Federal and State Guidelines, a contact lens prescription is valid for one year** Contact Lens Beginner Package This is required for the first time wearers or as refresher course. It is necessary to be instructed by an eye care professional as to the proper insertion and removal of contact lenses. As a liability our office policy is that no prescriptions will be valid without proper training. The training includes a contact lens starter kit, trial contact lenses, as well as an information sheet. Please set aside an hour for this appointment.

Contact Lens Beginner Package $49 (added to the Contact Lens Fitting / Evaluation Charge)

The training fee must be paid on the day services for the fitting are performed.

The patient will be responsible for a restocking fee of $25 if contacts lenses are not picked up within a 30 day period and returned to distributor.

Please sign below that you have read the information provided. If you have any questions please feel free to ask us.

______Patient Signature Date