Get Contact Lens Instruction Guide

This guide provides clear, step-by-step instructions on how to complete the Contact Lens Instruction Guide online effectively. Follow these instructions to ensure your information is accurately recorded and submitted.

Follow the steps to complete your Contact Lens Instruction Guide.

1. Press the ‘Get Form’ button to access the form and open it in your preferred online editor.
2. Begin filling in your personal information. Provide your first name, last name, middle initial, preferred name, birth date, and the last four digits of your Social Security Number. Select your sex and occupation as needed.
3. Enter your home address, including city, state, and zip code. Specify your contact preferences by indicating which phone number we should use.
4. Provide your email address and marital status. Ensure you are ready to bring a copy of your insurance cards for verification.
5. Detail your primary, secondary, and vision insurance information, including the policy holder's last four digits of their Social Security Number, their name, birth date, and employer.
6. Indicate who your family doctor is and their contact information. List any family members who are also patients at this office.
7. Fill in how you heard about our services and provide the name of the individual who referred you, if applicable.
8. Review and acknowledge the Notice of Privacy Practices, Authorization to Release Information, and Consent for Treatment sections by understanding the implications before moving forward.
9. Provide your Chief Complaint, indicating any relevant symptoms you are currently experiencing. Check all that apply.
10. Complete the History of Present Complaint section by describing details such as location, severity, duration, and context associated with your symptoms.
11. Fill in the Family History section, indicating any hereditary conditions that may be applicable.
12. Complete the Social History section by answering questions regarding smoking and alcohol use.
13. If you wear glasses or contact lenses, provide details about your current eyewear and lens specifications.
14. Fill out the Review of Systems section, checking any issues that apply to you across multiple health systems.
15. List any medications you are currently taking and any allergies you may have.
16. Review your completed form for accuracy before saving changes. Choose to download, print, or share the form as needed.

Complete your documents online today for a streamlined experience.