Dear Contact Lens Patient,
Please Note: As of October 16, 2020 the Centers for Disease Control and Prevention (CDC) requires all contact lens wearers to read and sign the Contact Lens Prescription Acknowledgment form prior to the refill of your prescription. We will be unable to fill your new prescription without a copy of this form on file.
Thank you, Dr. Matejka & Staff
Please Note: As of October 16, 2020 the Centers for Disease Control and Prevention (CDC) requires all contact lens wearers to read and sign the Contact Lens Prescription Acknowledgment form prior to the refill of your prescription. We will be unable to fill your new prescription without a copy of this form on file.
Thank you, Dr. Matejka & Staff
Please fill out the Contact Lens Prescription Signed Acknowledgement Form prior to ordering your lenses, Thank You.