Richmond Eye Experts | Elite Family Vision
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Eye Exam for Glasses
Description:
Comprehensive health check with retinal imaging and glasses prescription. Retinal imaging required for patients > 5 years of age ($39 copay).
Comprehensive health check with retinal imaging and glasses prescription. Retinal imaging required for patients > 5 years of age ($39 copay).
Eye Exam for Contact Lenses
Description:
Comprehensive health check with retinal imaging, contact lens evaluation and glasses prescription. Additional fees apply for the contact lens evaluation. Retinal imaging required for patients > 5 years of age ($39 copay).
Comprehensive health check with retinal imaging, contact lens evaluation and glasses prescription. Additional fees apply for the contact lens evaluation. Retinal imaging required for patients > 5 years of age ($39 copay).
Medical Examination
Description:
Please choose this option if you have non-vision related complaints such as Dry Eye, Redness, or need a Diabetic Eye Exam. This exam will not include a refraction or glasses prescription. Medical insurance copays and deductibles apply. A payment of $75 will be collected on the day of your exam if your insurance company does not provide a cost estimate.
Please choose this option if you have non-vision related complaints such as Dry Eye, Redness, or need a Diabetic Eye Exam. This exam will not include a refraction or glasses prescription. Medical insurance copays and deductibles apply. A payment of $75 will be collected on the day of your exam if your insurance company does not provide a cost estimate.
Medical Testing - Returning patients only.
Description:
Applicable to patients who are returning for Special Testing, Glaucoma Management or Retinal Disease Management. Medical Insurance copays and deductibles apply. A payment of $75 will be collected on the day of your exam if your insurance company does not provide a cost estimate. Only available at the Richmond location.
Applicable to patients who are returning for Special Testing, Glaucoma Management or Retinal Disease Management. Medical Insurance copays and deductibles apply. A payment of $75 will be collected on the day of your exam if your insurance company does not provide a cost estimate. Only available at the Richmond location.
Orthokeratology Follow Up - Returning patients only.
Description:
Applicable to patients who are returning for Orthokeratology treatment. Special Charges apply. Only available at the Richmond location.
Applicable to patients who are returning for Orthokeratology treatment. Special Charges apply. Only available at the Richmond location.
Medicare Patients
Description:
Comprehensive health check with retinal imaging and a glasses prescription. Retinal imaging required for patients > 5 years of age ($39 copay). Extra charges apply for services not covered by Medicare (Refraction and Wellness Screening).
Comprehensive health check with retinal imaging and a glasses prescription. Retinal imaging required for patients > 5 years of age ($39 copay). Extra charges apply for services not covered by Medicare (Refraction and Wellness Screening).
Atropine therapy follow up - Returning patients only.
Description:
Applicable to patients who are returning for Myopia Management. Special Charges apply. Only available at the Richmond location
Applicable to patients who are returning for Myopia Management. Special Charges apply. Only available at the Richmond location
Myopia Management Soft Lens Follow Up - Returning patients only.
Description:
Applicable to patients who are returning for Myopia Management. Special Charges apply. Only available at the Richmond location.
Applicable to patients who are returning for Myopia Management. Special Charges apply. Only available at the Richmond location.
Free Myopia Consultation
Description:
This is a screening visit only - no prescriptions will be provided.
This is a screening visit only - no prescriptions will be provided.
Selection Required
- Dr. Nikkolai Sales
- Dr. Thi V. Le
- Dr. Zebin Dholasaniya
- Dr. Jordana Chettiparampil
- Any Available Provider
- PLEASE DO NOT USE THIS PORTAL FOR EMERGENCIES. CALL THE OFFICE A.S.A.P FOR A SAME DAY VISIT. (If you think you may have an eye infection, injury, sudden vision loss, or if you are seeing flashes or floaters, we would like to see you today.)
- Please note that ALL ROUTINE VISION EXAMS will include a $39 copay for retinal imaging for all patients. Extra charges may apply to patients coming in for Contact Lens evaluations.
- Scheduling is limited to 3 family members per day. We reserve the right to reschedule appointments and you will be notified if we do so.
- Please note that there is a $25 fee for same day cancellations or no shows. As a courtesy please let us know 24 hours ahead of time if you cannot come in for your appointment. Outstanding cancellation fees will need to be paid before scheduling another examination.
- We have reserved appointment slots for Ortho K or specialty contact lens follow ups. Please call the office at (832) 685-2020 if you require these spots.
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- PLEASE DO NOT USE THIS PORTAL FOR EMERGENCIES. CALL THE OFFICE A.S.A.P FOR A SAME DAY VISIT. (If you think you may have an eye infection, injury, sudden vision loss, or if you are seeing flashes or floaters, we would like to see you today.)
- Please note that ALL ROUTINE VISION EXAMS will include a $39 copay for retinal imaging for all patients. Extra charges may apply to patients coming in for Contact Lens evaluations.
- Scheduling is limited to 3 family members per day. We reserve the right to reschedule appointments and you will be notified if we do so.
- Please note that there is a $25 fee for same day cancellations or no shows. As a courtesy please let us know 24 hours ahead of time if you cannot come in for your appointment. Outstanding cancellation fees will need to be paid before scheduling another examination.
- We have reserved appointment slots for Ortho K or specialty contact lens follow ups. Please call the office at (832) 685-2020 if you require these spots.
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Your optometrist will determine whether to bill your visit under vision or medical insurance based on your symptoms, diagnosis, and treatment plan. We will text your copay information to the phone number you provide on this form. You may be responsible for any unpaid deductibles, and if applicable, we may bill any remaining balance after we receive the explanation of benefits from your insurance provider.
By scheduling this appointment, you agree to our billing policies. If you have any questions, our team is happy to assist you.
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