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Annual Contact Lens Agreement At St. Rose Eye Care, we carry the latest in contact lens technology, and specialize in the difficult to fit patients. This includes astigmatismcorrecting lenses (Toric),
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How to fill out annual contact lens agreement
How to fill out annual contact lens agreement
01
Start by reading the agreement thoroughly to understand the terms and conditions.
02
Fill out your personal information such as name, address, phone number, and email.
03
Provide details about your eye prescription including the type of lenses, prescription strength, and brand.
04
Indicate the frequency of lens replacement, whether it is daily, bi-weekly, or monthly.
05
Sign and date the agreement to acknowledge your understanding and acceptance of the terms.
06
Keep a copy of the completed agreement for your records.
Who needs annual contact lens agreement?
01
Anyone who wears contact lenses and wants to ensure they have access to their prescribed lenses on a regular basis should have an annual contact lens agreement.
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What is annual contact lens agreement?
Annual contact lens agreement is a contract between an eye care provider and a patient for the purchase and use of contact lenses over a one-year period.
Who is required to file annual contact lens agreement?
Both the eye care provider and the patient are required to sign and file the annual contact lens agreement.
How to fill out annual contact lens agreement?
To fill out the annual contact lens agreement, both the eye care provider and the patient must provide their contact information, prescription details, payment terms, and agreement on the terms and conditions.
What is the purpose of annual contact lens agreement?
The purpose of annual contact lens agreement is to ensure that the patient receives the correct contact lenses, follows the prescribed wearing schedule, and commits to regular check-ups with the eye care provider.
What information must be reported on annual contact lens agreement?
The annual contact lens agreement must include the patient's name, contact information, prescription details, payment terms, wearing schedule, and any terms and conditions agreed upon by both parties.
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