Optic Gallery Contact Lens/ Eyeglass Communication

Optic Gallery Contact Lens/ Eyeglass Communication

In accordance with the fairness to contact lens consumer act, and the eyeglass rule. We are required to present you with your finalized eyeglass and/or contact lens prescription following your evaluation. Please print and sign below that you have received your prescription for our files.

I

attest that I have received my finalized eyeglass and/or contact lens prescription from my eye care professional at Optic Gallery.
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Date

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