I authorize all doctors at Norman & Miller Eyecare to release any information including the diagnosis and the records of any treatment rendered to me or my child during the period of such eye care to third party payers, health practitioners, and/or employers until requested in writing.


I assign all insurance benefits, if any, to Norman & Miller Eyecare for services rendered. I understand that I am financially responsible for all charges whether or not paid by insurance. I understand that the exam and materials must be paid for in full at the time of service. We accept cash, check, and all major credit cards. 


An overdraft fee of $25.00 will be assessed for all returned checks. Patient(s) shall still be responsible for any attorney fees, collection agency fees, cost of collection, court costs and any other expenses or fees.


Contact lenses examinations may be subject to a contact lens fitting fee or a refitting fee with one free follow-up appointment. All other contact lens checks, or follow-up appointments may include additional fees.  I understand there is a 90-day policy on contacts and after 90 days Norman & Miller Eyecare cannot accept returns of boxes of contacts.


I understand every pair of eyewear purchased from Norman & Miller Eyecare is custom made to my needs and cannot be returned. In the event of a refund, I understand I may be charged a restocking fee of 50%. I understand if I choose a less expensive frame or lens option, fees may be retained by Norman & Miller Eyecare.


I have read the contents of this page and understand by signing my name, I agree to all terms and conditions.

I have read the Norman & Miller Eyecare HIPAA Notice of Privacy Policy either on the website or in the office.

Click here to read our HIPAA Notice of Privacy Policy

Norman & Miller Eyecare

Terms & Conditions