Contact Lens Compliance Agreement

I am a first time contact lens wearer. I understand that it is my responsibility to seek training on the insertion, removal,
and handling techniques of contact lenses.I agree to follow the instructions given to me by Eye Bank. I understand that my cleaning and wearing schedules are very important in maintaining my contact lenses and the health of my eyes. I understand that improper use of my contacts can lead to permanent vision loss. I also understand that by wearing contacts I am increasing my risk for eye infections, allergies, and other eye complications.

I am to remove my contacts immediately and call my eye doctor if:

1) Unusual burning, irritation, redness, pain, or watering of the eyes occurs
2) Vision becomes blurry
3) I suspect something is wrong.
I must build up my wearing time according to the schedule specified by manufacturer.

By signing , I understand and agree to all the terms outlined on this form.