[et_pb_menu_4 background_layout="primary-menu" menu_layout="inline" _builder_version="3.5" /] Contact Lens Evaluation A contact lens evaluation is required every year in order to purchase contact lenses. A contact lens prescriptions expire every twelve months. Your contact lens exam fees are determined by the examination services, contact lens design, follow up services required, and overall complexity of your specific situation. Your Contact Lens Evaluation Includes: History and Medical Visual Need Visual needs analysis Prescription considerations Medical considerations/contraindications for wear Recommendations for proper UV protection Clinical Examination Visual acuity measurement Corneal curvature assessment for proper contact lens design Corneal integrity Corneal sensitivity Eye aperture size analysis Eyelid evaluation Biomicroscopic observation of the eye Biomicroscopic evaluation of proper contact lens positioning and movement Tear flow analysis as it relates to the quality and quantity of tears Tear film analysis as it relates to contact lens comfort Vertex distance conversions based on patient prescription Contact lens application Progressive Evaluations Instruction on timely lens disposal and return visit reminders Progress evaluations as required to check or healthy contact lens wear Follow-up care/CL Prescription Evaluation x 90 days Patient Instructions (when applicable) Instructions on proper cleaning, storage, and disinfection of contact lenses Techniques and tips on application and removal of contact lenses Instruction on contact lens care and handling Advice regarding use of makeup and/or other cosmetics with contact lenses Information regarding the use of contact lenses for sports Precautions regarding contact lenses and swimming Emergency and Follow Up Care Answers to your contact lens related questions in office or by phone Advice on how to identify a contact lens emergency I understand that I am opting for a contact lens evaluation, an additional fee, which varies based on the complexity of the contact lens fit and the likelihood of follow-up visits.Parent/Guardian Name* Date*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Signature*PhoneThis field is for validation purposes and should be left unchanged. Office Hours Monday 9:00am - 5:00pm Tuesday 9:00am - 5:00pm Wednesday 10:00am - 6:30pm Thursday 9:00am - 5:00pm Friday 8:00am - 3:00pm Saturday Closed Sunday Closed