Patient Information regarding Contact Lens Fittings by shuifanglj


									            Patient Information regarding Contact Lens Fittings

A regular eye exam generates and Rx for glasses only.

When a patient wants a contact lens exam, a ‘fitting’ is required.
There is an additional charge for this time which is called a ‘fitting fee’. This fee is for
the additional exam time and the trial contacts that you will be ‘fitted’ with. It also
includes follow-up appointments as needed until you have been ‘fitted’ satisfactorily.

The charge for a contact fitting fee is either $45 or $55 depending on the lens type.
This charge is to be paid at the time of service.

If your vision insurance includes contact lens coverage, your fitting charge may be
included in the contact lens allowance, depending on the insurance benefit schedule.

Accepted by ____________________________________________ Date ___________

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