For Office Use Only: NP/EP ___ | GLS/CLE | OM / OK Dilation | Reschedule Dilation | Date:_____________
Vision Insurance Information
If you have tested COVID positive within the last week, we kindly ask you to reschedule your appointment for 10 days after the positive test.
Internal Ocular Health Evaluation
This office will make every effort to perform a complete retinal evaluation with each comprehensive eye exam. The internal ocular evaluation is an important component of a routine eye examination since many eye problems can develop without symptoms.
The internal ocular evaluation involves using dilating eye drops, which is included in the comprehensive exam at no charge. Be advised that you may experience blurred vision when reading and an increase in light sensitivity, which can remain for up to 4-6 hours. If today is not convenient, the dilation may be rescheduled at no charge. We also offer a non-contact wide view imaging system, Optomap, that allows the doctor to capture hi-res images of your retina which can be performed quickly and without any symptoms. This is an additional $29 fee for each patient. This can be further discussed on the day of your appointment.
*For individuals that order glasses online, this office does not provide pupillary distance (PD) to patients.
The state of Georgia requires that a contact lens fitting be performed every 12 months to update contact lens prescription, in order to maintain eye health.
This applies to all patients, even if you may have worn contact lenses in the past or if the prescription does not change.
Contact lens prescriptions will be released to the patient upon completion of the fitting process. The fitting fee includes follow-up visits for up to 2 MONTHS from the initial evaluation regardless of lens type or modality. If follow-up visits are needed after 2 months, additional office visit charges may apply.