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PRESCRIPTION FORM - ZZ medical

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The document is a prescription form for Z&Z Medical, Inc., used to order eyewear prescriptions. It includes sections for single vision, bifocal, and progressive prescriptions, requiring specific information such as sphere, cylinder, axis, prism details, and pupillary distance. The form must be faxed or emailed to the provided contact information.

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Versions	Form popularity	Fillable & printable
2017	4.3 Satisfied (54 Votes)
2009	5 Satisfied (48 Votes)

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Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

What do eye prescriptions mean?

Commonly, this number will be different for each eye. A + in the box indicates that you are long-sighted which means you find it difficult to see things close to you. A shows that you find it hard to see things that are far away without glasses. The number might be very small, like 0.25, or a large number, like 6.00.

What is an eye prescription?

Parts of a prescription Prescriber information: The doctors name, address and phone number should be clearly written (or preprinted) on the top of the prescription form. Patient information: This portion of the prescription should include at least the first and last name of the patient and the age of the patient.

What does a +0.25 eye prescription mean?

Positive numbers on an eye prescription indicate they are correcting farsightedness, while negative numbers correct shortsightedness. A larger number suggests a stronger prescription.

What is on a prescription form?

It contains all the details of the medication prescribed by the physician (or prescriber), such as the prescribers information, patient information, medication prescribed including the name, dose, and dosage form, dispensing instructions, and number of refills.

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