18
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.
Name and Address of Manufacturer:
Bausch & Lomb Incorporated
Rochester, New York 14609
