Patient Forms & Policies | DeWitt Eyecare

Patient Forms

Please download and print the following forms prior to your appointment. If you have any questions regarding our patient forms, feel free to give us a call.

Patient Consent Form

Dry Eye Questionnaire

Medical History Form

Shipping Policy

Under normal circumstances, most orders ship out within 24-48 hours. However, due to large order volumes, weather conditions, circumstances beyond our control, special order items, etc. shipping times may take longer.

Shipping will be paid in full prior to your order being shipped. We will inform you of special free shipping promotions for contact lenses when available. For more details, please call our office 563.659.2020.

Refund/Return Policy

Frames

DeWitt Eyecare will adjust frames and replace any screws free of charge for frames purchased from our offices.

All frames come with a 1-year warranty against manufacturer defects. While the manufacturer determines eligibility, our eyewear consultants will do all possible to rectify any issues. A $45 warranty fee will be charged for any replacements.

If a patient chooses to place new lenses into an older frames, we cannot be held liable for breaks or damage.

A frame re-style may be available to a patient within 90 days of the order date. A $45 frame re-style fee will be charged to the patient.

Lenses

Lens remakes and doctor verifications will be granted within 90 days of the order date if the lenses were made through DeWitt Eyecare under the following conditions:

prescription change
measurement change
lab error

If a patient seeks a doctor verification 90 days after the lenses were received, the patient will be charged a $75 re-check fee.

If lenses were made by an outside office, we will measure the prescription in the new glasses to verify accuracy. Patients will not be reimbursed any fees an outside office charges for remakes. If a patient requests a doctor verification, they will be charged a $75 re-check fee.

If a patient chooses to upgrade their lens options they must pay any applicable upgrade charges.
If a patient chooses to downgrade their lens options: no refund will be provided, however, we will remake the lenses at no additional cost.

Lens manufacturer warranties vary, with dates commencing from the date of purchase. See one of our eyewear consultants for you warranty details. A $45 warranty fee will be charged for replacements.

Contact Lenses

Any exchange of contact lenses will be disqualified if the boxes received are opened, marked, or expired.

If materials are approved for exchange, the patient will be credited the amount they spent on the lenses at the time of purchase and will be able to use those funds towards the updated order.

Doctor verifications will be granted, free of charge, within 90 days of the order date if the lenses were purchased through DeWitt Eyecare.

Lens exchanges due to defect are available to those who purchased the lenses through DeWitt Eyecare.

Cancellations

In the event a patient wishes to cancel an order, it must be done by the close of business on the day of order to receive a full refund. Refunds requested after this point will include a $45 restocking fee and any additional lab fees.