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ISON Agreement

The I See Over Night Program includes the flilowing:
  • Initial ISON Evaluation, fitting, and consultation
  • ALL lens changes made by the doctor for the first 12 months
  • Two pairs of retainer lenses; 2nd pair will be dispensed after treatment has been stabilized
  • All flilow-up care for the first two years; including 1st yearly evaluation after the initial enrlilment
  • All topographical and diagnostic testing
After the first two years (2 years), the I See Over Night Program does not include:
  • Annual Comprehensive eye health exam
  • I See Over Night Maintenance Program
Cost for yearly exams, after the two year (2 year) Program has ended, is $365 every 12 months. If more than 12 months has passed, evaluation will be $377.

Guarantee:

  • If Circumstances prevent you from continuing your treatment during the first three months (3 Months) of care, EyeSymmetry will gladly refund all fees paid less $700.
Fees:
Option: Interest-Free Financing
LEVEL 1$2250
LEVEL 2$2750
LEVEL 3$3300
LEVEL 4$3600
LEVEL 5$4400
* If payment is made in full at the time of the purchase, without any special financing, there will be a special discount of $229.00 (Two hundred twenty nine dollars)

In the Event that a retainer lens has to be replaced, there is a replacement fee.
Lens Replacement fee (per lens)
Single Vision Lens$265
Multi-focal Lens$365
*Prices are subject to change without notice*
Patient Name:
MM slash DD slash YYYY

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