Please note: Insurance may cover none or only part of your fees. If we do not accept direct payment from your insurance plan, payment is expected at the time of services and we will be happy to provide you with a receipt to submit to your insurance company for reimbursement. If your insurance does not pay as expected, you are ultimately responsible for all charges. We will be happy to assist you with your claims. Please give any forms to the receptionist. If you are using insurance: I authorize the release of any medical or other information necessary to process this claim. I accept responsibility for payment of products and services.
NOTICE: There is a contact lens evaluation fee in addition to the exam fee.Agree and Continue