Section R4-21-306. Optometric Prescription Standards; Release to Patients

A.       When a licensee completes an eye examination and generates an optometric prescription, the licensee shall provide the patient with a copy of the optometric prescription without charging a fee other than the examination fee.

B.       A licensee shall ensure that an optometric prescription written by the licensee includes:

1.        For ophthalmic lenses other than contact lenses:

a.         Name of the patient;

b.        Refractive power of the lenses;

c.         Interpupillary distance;

d.        Printed name office address, telephone number, and signature of the licensee; and

e.         Date of the examination and expiration date of the prescription;

2.        For contact lenses, including plano lenses:

a.         Name of the patient;

b.        For a patient who has not completed a trial period appropriate under the circumstances and desires to have a prescription, the information required for the patient to purchase trial lenses at another optical establishment or location;

c.         For a patient who has completed a trial period appro- priate under the circumstances for the lenses pre- scribed, all information necessary to reproduce the contact lenses accurately;

d.        Printed  name,   office  address,  telephone  number, license number, and signature of the licensee;

e.         Date of the examination and the issue and expiration date of the prescription; and

f.         Information regarding the prescribed contact lenses:

i.         Refractive power;

ii.        Base curve or other appropriate designation;

iii.      Diameter, if appropriate;

iv.       Tint, if applicable;

v.        Material, manufacturer, or both; and

vi.       In the case of private-label contact lenses, man- ufacturer, trade name, and, if applicable, trade name of equivalent brand name; and

3.        For pharmaceutical agents:

a.         Name and address of the patient;

b.        Date the prescription is issued;

c.         Name, strength, and quantity of the pharmaceutical agent prescribed;

d.        Directions for use of the pharmaceutical agent pre- scribed;

e.         Name, office address, and telephone number of the prescribing licensee;

f.         DEA number of the prescribing licensee;

g.        Two  adjacent  signature  lines  with  the  following printed words:

i.         “Dispense as written” under the left signature line, and

ii.        “Substitution permissible” under the right sig- nature line; and

h.        Original signature of the prescribing licensee on one of the signature lines; and

4.        Additional information that the licensee considers neces- sary.

C.       A licensee who dispenses or directs the dispensing of oph- thalmic materials shall ensure that a prescription is filled accu- rately.

D.       A licensee shall be available to verify that a prescription writ- ten by the licensee but filled by another provider of ophthalmic goods is accurately filled. The licensee may charge a fee for verifying the accuracy or quality of ophthalmic goods dis- pensed by another provider.

Historical Note

Adopted effective February 7, 1986 (Supp. 86-1).

Amended effective April 1, 1991 (Supp. 91-2). Section R4-21-306 renumbered to R4-21-307; new Section R4-

21-306 adopted effective November 5, 1998 (Supp. 98-

4). Amended by final rulemaking at 11 A.A.R. 1864,

effective May 3, 2005 (Supp. 05-2). Former R4-21-306 renumbered to R4-21-307; new R4-21-306 renumbered from R4-21-305 and amended by final rulemaking at 14

A.A.R. 12, effective February 2, 2008 (Supp. 07-4).