14
CHeCk-uP Visits
Regular check-up examinations by your eye care professional are an important part of wearing contact lenses. It is recommended
that you follow your eye care professional’s directions for follow up examinations. Keep all appointments for your check-up visits. If
you move to a new city, ask your present eye care professional to refer you to a contact lens professional in your new location. Use
the space below to record your appointments.
Visit sCHedule
1. __________________________________________________________________________________
Date Time
2. _________________________________________________________________________________
Date Time
3. ________________________________________________________________________________
Date Time
4. ________________________________________________________________________________
Date Time
5. ________________________________________________________________________________
Date Time
6. ________________________________________________________________________________
Date Time
7. ________________________________________________________________________________
Date Time
8. ________________________________________________________________________________
Date Time
9. ________________________________________________________________________________
Date Time
10. _______________________________________________________________________________
Date Time
eYe Care Professional information
Please fill out for readY use
Name: _____________________________________________________________________________
Address: ____________________________________________________________________________
Phone: _____________________________________________________________________________
Other Information: _____________________________________________________________________
IMPORTANT: In the event that you experience any difficulty wearing your lenses or you do not understand the instructions given
to you, DO NOT WAIT for your next appointment. TELEPHONE YOUR EYE CARE PROFESSIONAL IMMEDIATELY.
