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  • Medical History

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  • Please indicate if you have been diagnosed with any of the following medical conditions.
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  • General Consents

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  • Internal Ocular Health Evaluation

    Since many eye problems can develop without symptoms, an internal ocular evaluation is an important component of a routine eye exam. To accomplish a full internal health assessment, our doctors highly recommend that all patients have a retinal scan (Optomap) and pupil dilation. The Optomap captures a digital image of about 80% of the inside of the eye without side effects but most insurances do not cover it. The pupil dilation is achieved by applying a series of drops and can take 15-20 minutes to take effect and about 4-6 hours to wear-off.  It is advised that these services are completed the same day of the yearly exam to avoid extra charges especially since some insurances only cover one routine eye exam visit per year. Be sure to plan your visit accordingly. 

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  • Contact Lens Prescription Renewal Policy

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  • To purchase contact lens materials its required by law to have an active contact lens prescription.  This applies to all patients, even though you may have worn contact lenses in the past and/or even if the prescription does not change. The state of Georgia requires that a contact lens evaluation be performed every 12 months to renew contact lens prescriptions.

    To comply with contat lens wearer laws your contact lens prescription will be issued right after the contact lens examination via the Dr. Contact Lens Portal.  If trials need to be ordered we strongly advised to postpone ordering any contact lens supply until satified with the issued lenses.  And if you are not fully satisfied with dispensed or ordered trial lenses its impeartive that you schedule a contact lens follow up as soon as possible.  Contact lens follow-ups must be perform with in 45 days of initial exam to avoid extra charges and its the patients responsibility to schedule them if needed.  Addition fee's are listed below.  There are certain patients that use specialty lenses and those prescriptions will be issued to the email provided. If a patient requires multiple contact lens prescriptions, fittings or evaluations, additional charges will apply. Payment for contact lens evaluations to renew contact lens prescriptions, as well as with all other professional fees, is non-refundable.

  • CONTACT LENS EVALUATION FEES are based on the complexity of evaluation.

    Soft Standard Fitting $60
    Soft Extended Wear Fitting $80
    Soft Color Fitting $80
    Soft Astigmatism Fitting $80
    Soft Monovision Fitting $90
    Soft Multifocal Fitting $90
    Hybrid Standard Fitting $135
    Hybrid Multifocal Fitting $155
    Hybrid Keratoconus/PS Fitting $215
    Gas Permeable Standard Fitting $120
    Gas Permeable Premium Fitting $150
    Semi Scleral Fitting $350

    The contact lens evaluation fee is non-refundable and only includes up to two follow-up visits within a 45 day period from the initial exam. If additional visits are needeed, additional fees will apply. 

     

    ADDITIONAL FEES

    Additional 20 minute training session $29
    3rd visits or if it's after the 45 day period $29
    For visits 3 months after initial exam $68
    For visits after 6 months from initial exam Full Exam Cost

     

    Return Policy

    If you purchased contact lenses from our office and are dissatisfied for any reason with the purchase materials, the following polices will apply.

    Certain, soft contact lens boxes can be returned for credit or refunded within 60 days of purchase. As long as the boxes are unopened, undamaged, and unmarked.

    Furthermore, if boxes are returned and a courtesy diagnostic lenses were supplied at the time of purchase, a dispensing fee will apply.

    Certain toric (ex: XR lenses), color (BioColors, Eyedia) and custom lenses are non-refundable once the order has been placed.

    Gas Permeable, scleral, hybrid, and some soft contacts are made to order and can also be returned within 60 days, but a $35 re-stocking fee per lens is required depending on lens type, manufacturer and design.

    If lenses were shipped to home and do not arrive in the expected time; we need to be notified immediately. As with any return, exchange or claim needs to be submitted to distributor and manufacturer within 60 days of order for investigation. 

    Lastly, if any contact lens product is not picked up within 6 months of inital order and we are not able to establish communication; the lenses will be destroyed as no refund would be issued as they would have exceeded the 60 days period for any returns from manufacturer or distributor. 

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