Part Number: PIB01012
Page 16 of 18
Revision A
Revision Date: June 2016
12
.
EYE CARE PRACTITIONER INFORMATION
To aid your ability to reach you eye care practitioner, please record the contact details below.
Dr:
______________________________________________________________
Address:
______________________________________________________________
Phone:
______________________________________________________________
Use the table below to record the number of hours you wear your lenses each day during the adaptation
period.
Day
Date
Hours Worn
Day
Date
Hours Worn
1
8
2
9
3
10
4
11
5
12
6
13
7
14
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
PRACTITIONER IMMEDIATELY.
Notes_______________________________________________________________________________
____________________________________________________________________________________
