Alcon 2024 ASSIST Opt-in

ASSIST Empower Plan

The ASSIST Empower plan is designed to help practices increase patient engagement. Please fill out the information below for Eye Care Providers that are interested in the ASSIST Empower Plan.
Would you like to participate in the 2024 ASSIST Empower Plan?*

Yes! Please contact me to setup my plan.Maybe. I would like more information.
Alcon Rep Name
Please provide the Eyecare Provider's information below.
Practice Name*
Doctor(s) Names*
Please list the Doctor(s) practicing at this location.
Optical Vision Center Phone Number*

Area CodePhone Number
Optical Vision Center Website
Optical Vision Center Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Please provide the Practice Owner's information below.
Practice Owner's Name
Best Phone Number

Area CodePhone Number
Email
Legal Business Name
Best Times Of Day To Contact

Before 8AMBetween 8AM-11AMBetween 11AM-2PMBetween 2PM-5PMAfter 5PM
Best Days Of Week To Contact

MondayTuesdayWednesdayThursdayFriday
Questions or concerns? Let us know and we will reach out to discuss further.
By clicking submit, I confirm, I am at least 18 years old, am a Healthcare Professional, and I have read and agree to Alcon’s Privacy Notice and Terms of Use.
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ASSIST Empower Plan