• VISION TRAINING AGREEMENT

  • The Vision Training Program will commence on    , 20   and end on    , 20    and includes:

    • » 12 weeks of in-office vision training sessions, scheduled once per week
    • » Training sessions are 45 minutes in length and begin at the top of the hour
    • » 1 progress evaluation by the provider around 10 weeks at no additional charge


    The fee for the Vision Training Program is: $1896.00
       
    $1896.00 – discount ($192.00) = $1704.00

       
    $1896.00 Interest free financing available through CareCredit. This option allows the cost of training to be split into interest free term financing paid monthly and dependent upon application approval from CareCredit.

    Choose one:         

       
    $1896.00 Split into 2 equal payments. 
    1st Payment: $948.00 Charged on/before the first day of training
    2nd Payment: $948.00 Charged on     
    A credit card will remain on file and will be charged on the dates above

  • Payment Options: Visa, MasterCard, American Express, Discover, CareCredit, HSA, Check, and Cash

    Each patient’s individualized Training Program has been prepared by a doctor. Training will be conducted by a trained Optometric Vision Therapist. As a patient progresses through the program, the amount and type of training required may change. This is due to improvements being made more, or less, quickly than anticipated. We are here to provide the best possible care for our patients and if you have any questions or concerns, please contact the office at any time.

    The Vision Development Team is an out of network provider for all health insurance companies. If requested, claim forms for services will be provided. Patients are responsible for mailing claim forms and corresponding with the insurance company.

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  • PH: 440-230-0923 Fax: 440-698-0013
    Email: info@sensoryfocus.com
    www.sensoryfocus.com

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