The Great EyeDeal
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"For many years as Vice President of Professional Services at Cole Vision, I partnered with the good folks at Great Eyedeal to provide our affiliated ...."  more
- Michael L. Cohen
O.D., F.A.A.O.
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Patient Forms
Various Practice Management Forms used during routine examinations. These forms meet all the requirements set forth by the Health Insurance Portability and Accountability Act (HIPAA). According to the HIPAA certification we are compliant with the requirements relating to privacy, confidentiality and security of individually identifiable health information.
Eye Exam Forms
- Cl2 Pvc C/L Rx 100/Pkg (Small)

Health/History Forms
- Contact Lens History Card

HIPAA Form
- HIPAA Access to Records Form
- HIPAA Complaint Form

Miscellaneous Forms
- Patient Record Release

Standard RX Forms
- Doctor Complete Rx
- Generic LifeStyle Rx With Contact Lens
- Prescription Form- For Spectacles Contact Lenses
- Prescription Pad-TPA

Great Eye Deal Please call 1-888-480-4835 ext. 145 between 8:00 AM and 5:00 PM CST. Mon. - Fri.
Voice mail available. All calls returned within 2 hours or less.
customercare@greateyedeal.com : www.greateyedeal.com : 1-800-422-2903 (fax)
Great Eyedeal 12100 Ford Road, Suite 100, Dallas, TX 75234