VE UBT Finalizes the Eyewear Analysis Form

UBT Committee’s last meeting on July 17, 2015 revised the Eyewear Analysis according to the constituent’s recommendations.Constituents asked that several changes be made and the committee listened and updated the Eyewear analysis form. Please see below for the revised Eyewear Analysis form.

Patient name: ***

MRN: ***

Date of OD recheck: ***

Member Concern: ***

Length of time Member has worn new rx? *** {DURATION :61052}

Dispense Date: ***

New spectacle verification (Lensometer Reading):

OD:*** -***x *** Add:*** Prism:*** BC:*** PD:*** Seg Ht:*** MF type: ***
OS:*** -*** x *** Add:*** Prism:*** BC:*** PD:*** Seg Ht: *** MF type: ***

Lens Material: ***

Vision Essentials Purchase: Y or N

Compensated Lens: Yor N

Prior/Preferred Pair spectacle verification (Lensometer Reading): ***(n/a)

OD:***   -*** x *** Add:*** Prism:*** BC:*** PD:*** Seg Ht: *** MF type: ***
OS:*** -*** x *** Add:*** Prism:*** BC:*** PD:*** Seg Ht: *** MF type: ***

Lens Material: ***

Vision Essentials Purchase: Y or N

Compensated Lens: Y or N

Adjustment Verified: Y or N

Panto Checked: Y or N

Eyewear analysis prepared by: ***

2nd Optician Verification by: ***

Original Optician: ***

Original formating prevails, this is a copy of the wording only.  The formatting does not carry over to this posting.

UBT is still working on Workplace Safety Project and is trying to come up with a video to demonstrate the workplace safety message to setting up your workplace station. It will involve setting up the chair, monitor and desk .                  Screen Shot 2015-08-01 at 7.45.50 AM

The message from the committee for you this month is :  How do you like the changes made to the Revised Eyewear Analysis?

Our next meeting will be August 21, 2015. If you have any questions or concerns, please don’t hesitate to call or email your UBT representative.

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