Patient Forms
Patient Forms
Welcome to Precision Eye Care of NJ
Precision Eyecare NJ
370 Highway 35, Suite 202
Red Bank, NJ 07701
Phone:732-842-9177
Monday:8:00 AM - 12:30 PM
1:30 PM - 5:00 PM
Tuesday:8:00 AM - 12:30 PM
1:30 PM - 7:00 PM
Wednesday:Closed
Thursday:8:00 AM - 12:30 PM
1:30 PM - 7:00 PM
Friday:8:00 AM - 12:30 PM
1:30 PM - 3:00 PM
Saturday:Please note we are here every second Friday 8am-12pm and every second Saturday of the month 8:30am-1pm. Please call ahead!
Sunday:Closed
Open 1 Saturday per month 8:30 AM to 1:00 PM
PRECISION EYE CARE CANCELLATION POLICY
Precision Eye Care's goal is to provide patients with quality eye care in a timely manner. We have implemented a NO SHOW and CANCELLATION POLICY which enables us to better utilize available appointments for our patients in need of care. The following policy is with regard to patients who fail to keep their scheduled office appointments.
Patients who fail to show up to their scheduled appointment or did not notify the office within 24 hours of their scheduled appointment time, shall be subjected to a "NO SHOW/CANCELLATION FEE" of $50.00. Consideration will be given, at doctor's discretion, in the event of an actual emergency where prior notice could not be given.
Please be courteous and call Precision Eye Care of NJ promptly if you're unable to attend your appointment. This time will be relocated to someone who is in urgent need of treatment. Available appointments are in high demand and your early cancellation will give another patient the possibility to have access to a visit.
The fee associated with the cancellation policy is not covered by the insurance and is therefore the sole responsibility of the patient.
TO CANCEL or RESCHEDULE please call or text (732) 842-9177. If you have any problem getting through, you can always leave a message with your name, appointment date and cancellation reason or request for rescheduling.
I certify that I have read and fully understand the above statements and consent fully and voluntarily to its contents. A photocopy of this consent shall be considered as valid as original.
Annual Contact Lens Agreement Precision Eye Care of NJ
Please carefully read our Contact Lens Agreement (opens in new tab). Contact lenses are medical devices that require additional testing to ensure safety and an accurate prescription. An annual contact lens evaluation is required every year for all contact lens wearers in order to prescribe contacts. The fee for this evaluation is separate from the fee for the routine eye exam and is not refundable. Some vision plans do cover all or part of this fee, while others do no. Any amount not covered by your vision plan is due In full at the time of service.
The contact lens evaluation does not include your annual supply of contact lenses, which can be ordered after the prescription has been finalized. It also does not include medical office visits for issues unrelated to the evaluation of your contact lenses, like dry eye, eye infection, injuries and ocular disease.
By signing this form, you are acknowledging that:
- Contact lens evaluation fees are non-refundable and payment is due at time of service.
-Your prescription is valid for one year.
- Proper care of your lenses is expected. Failure to properly care for your lenses may result in numerous eye problems, such as corneal ulcers and potential loss of vision.