Our office system utilizes text messages to cell phones and appointment confirmations via email:
If you wish to renew your contact lens prescription, please come to your appointment wearing your current contact lenses. A contact lens evaluation or refitting fee will be charged, as these services are not included in the well vision examination fee. By accepting a trial pair of contact lenses, you agree that a follow-up visit is required to finalize a new contact lens fitting. You will receive a copy of your contact lens prescription after appropriate follow-up visits have been completed. Contact lens prescriptions are valid for one year.
If you have any questions about your new glasses purchased from Moderne Eye, please see our Optician to verify the adjustment of the glasses and for further demonstration of the optics of specialty lenses. The examining Optometrist, at no additional cost, can verify your spectacle prescription within 60 days of the eye examination date.
New frames purchased at Moderne Eye Optometry are warranted by the frame manufacturer for defects. Frames that are being reused or purchased elsewhere are not guaranteed from any breakage or damage during the lens replacement process or frame adjustments. Frames purchased elsewhere will be charged a dispensing fee beginning at $50 per frame.
Payment for materials and services are due when services are rendered. We require payment in full for materials in advance of processing an order (this includes all extra charges not covered by vision plans). If you chose to cancel your prescription spectacle or contact lens order after your payment has been made, a 50% cancellation fee will be charged to cover our optical services. Orders will not be placed without payment in advance. If you have any questions, please ask.
We cover optical services (optical center measurements, pupillary distance, frame adjustments, frame warranty, some repairs) for glasses purchased at Moderne Eye. We do not verify nor provide adjustments for glasses purchased elsewhere. If you want us to provide an adjustment, at your own risk, the charge is $50 per eyeglass for an adjustment.
I acknowledge that I have been given the opportunity to review and/or have received a copy of Moderne Eye Optometry’s Notice of Privacy Practices.
*Add Link To Notice of Privacy Practice*
Moderne Eye Optometry is a participating provider of only these vision and medical plans.
Advance Beneficiary Notice:
I authorize Moderne Eye Optometry to submit my claim to VSP or Tricare or Medicare for eye care and materials services rendered. Depending on the benefits selected by your employer, your plan may not pay for a particular service or material. This does not mean that you should not receive these services or materials. We will provide an explanation of covered and non-covered benefits and it is your choice to receive these materials and services or to decline. An itemized bill is provided for your information and records. If Moderne Eye Optometry is not a participating provider for your specific insurance plan, your signature below is an agreement to pay for exam services and/or materials privately. By signing this form I acknowledge I have read and agree to the policies stated above. We are happy to provide the information necessary to help complete your insurance forms.