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CONTACT LENS FITTING AGREEMENT Wadsworth Eye Clinic, Inc 330.247.2480195 Wadsworth Rd Suite 304 Wadsworth, OH 44281Professional Fees: ($50 standard / $85 premium incl. topic, bifocal, rigid gas-permeable)

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How to fill out annual contact lens agreement

01

Make sure you have a current prescription for contact lenses from your eye care provider.

02

Read the annual contact lens agreement carefully to understand the terms and conditions.

03

Fill out your personal information accurately, including name, address, and contact information.

04

Provide details about your eye care provider, including their name and contact information.

05

Sign and date the agreement to confirm your understanding and acceptance of the terms.

Who needs annual contact lens agreement?

01

Individuals who wear contact lenses and want to purchase them from a specific eye care provider or retailer.

02

Anyone who wants to ensure they are receiving the correct type and quantity of contact lenses as prescribed by their eye care provider.

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What is annual contact lens agreement?

Annual contact lens agreement is a contract between a contact lens prescriber and a contact lens seller that establishes the terms and conditions for the sale and use of contact lenses.

Who is required to file annual contact lens agreement?

Both contact lens prescribers and contact lens sellers are required to file annual contact lens agreements.

How to fill out annual contact lens agreement?

To fill out an annual contact lens agreement, contact lens prescribers and contact lens sellers must provide information about their contact lens practices and agree to abide by certain regulations regarding the sale and use of contact lenses.

What is the purpose of annual contact lens agreement?

The purpose of an annual contact lens agreement is to ensure that contact lens prescribers and sellers are following regulations and best practices to protect the eye health of patients who wear contact lenses.

What information must be reported on annual contact lens agreement?

Information that must be reported on an annual contact lens agreement includes details about the contact lens prescriber's practice, contact lens seller's business, and agreements on compliance with regulations.

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