Office Policy

Office Policy Form

Thank you for choosing Tri-City Optometry as your health care provider. We pride ourselves on providing exceptional patient care. We understand that you have options when it comes to choosing your eye care professional. Should for any reason you find yourself less than fully satisfied with your glasses, contact lenses, or service please let us know and we will do our best to attend to your concerns.

Insurance Coverage Information
We will submit insurance claims as a courtesy to you. Insurance co-pays and fees for non-covered services are always due at the time of service. Most insurance companies have limitations: some pay a set amount, some pay a percentage and some pay nothing at all. Your insurance policy is a contract between you and your insurance company. Medical Insurance (such as Medicare, Blue Cross, etc.) may cover your exam and other needed services if you are having a problem with your eyes that is related to a medical condition. Vision Insurance will cover your eye exam if you are having problems related to glasses, contact lenses, or a "routine" check-up when there are no specific problems.

Eye Wear
We require a 50% deposit on all orders. If for any reason you are not satisfied with your new glasses we do not provide refunds. Although we will gladly exchange and or remake your glasses to your satisfaction within 90 days.

Refraction is a test to determine how well your vision can be corrected and your overall visual function. Even though it is an important part of any eye exam Medicare and most Medical Insurances, including Medicare secondary plans do not cover this service. Your current refraction fee is $50.

Providing Your Own Frames
We will be happy to make prescription lenses if you choose to bring in your own frames. In a small percentage of cases, the frame may not hold up during the process of customizing your lenses and may break or get damaged. Please understand that replacement parts may not be available for older and/or discontinued frames. We want to be sure that you understand that if your frame gets damaged we can't be held responsible.

Frame Warranty
If a new frame proves to be defective it may be replaced within 365 days of your order. It is up to the manufacturer's discretion as to what is considered defective. If your frame does break please do not use any type of glue, which would void your warranty. Please just put your glasses in your case and bring it in for us to repair.

Spectacle Lens Guarantee
If for any reason you are not 100% satisfied with your new lenses, Tri-City Optometry will remake the lenses within ninety days into the lens of your choice that is equal or lesser value (single vision, bifocal, trifocal, and progressive) at no additional charge.

Lens Material & Anti-Reflective Warranty
All impact resistance material and anti-reflective coatings are subject to the warranty policies of the coating manufacturers. When cleaning lenses please use the spray we provide or warm soapy water (Dawn or an anti-bacterial soap). For dying purposes, we suggest using the cloth we provide or a 100% cotton cloth.

Contact Lens Policy/Evaluation and Fitting Fees
When a Contact Lens prescription is needed, additional services and fees are required that are not part of the routine eye exam. Contact lens prescriptions expire one year from the date of the finalized prescription. Our fees vary on the complexity and type of the contact lens. Prices will range at the annual evaluation of lenses from $40-$150. If there has been a change that will require trial lenses and additional follow-up visits the fee will start at $60. We offer benefits for you when purchasing your contact lenses from Tri-City Optometry. We will provide trial lenses while waiting for your contact lens order to arrive or hold you over until your next eye exam. Unopened boxes of contact lenses may be returned for credit or exchanged if the contact lens prescription is modified by the doctor. Boxes must be unmarked and in good condition. These policies do not apply when purchasing your contact lenses elsewhere.

Pick Up Policy
Eyewear not claimed within ninety days is subject to forfeit of the deposit and will be returned to the manufacturer. Contact lenses not claimed after thirty days will be returned to the manufacturer.

Cancelation Policy
All Orders are a custom process and involve fixed costs to our practice. Orders canceled after a deposit is left could be subject to a fee of the total material cost.

Missed Appointments
If you cannot keep your appointment, please inform us at least 24 hours in advance. If we are not notified of your change of plans, then we must regrettably charge you a $25 fee.

Thank you for understanding our policies. If you have any questions or concerns, please do not hesitate to ask us.

I have read and understood the above.

Name of the Patient