New Patient Forms

Adults and Children (Age 10+) Health History Form 

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Children (Age 9 and below) Health History Form

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Returning Patient Forms

Adults and Children (Age 10+) Consent Form 

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Children (Age 9 and below) Consent Form

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Insurance Information

Shamrock Family Eye Care accepts a number of different medical and vision insurance plans. If your insurance plan is not listed below or if you are concerned about the eligibility of your insurance plan, please feel free to call our office. Each medical and vision insurance plan is unique and may offer different vision services to each of its members. We will attempt to verify all eye care coverage before your appointment.

We accept the following vision insurance:

We accept the following medical insurance:

If you don’t see your insurance listed, please email us or call 614.889.8331 to inquire.


Contact Lens Exam

What to expect during your Contact Lens Exam

Routine eye exams do not include the evaluation, diagnosis and fitting of contact lenses and a separate fee will apply for all Contact Lens Exams.

Shamrock is committed to the highest level of contact lens care and service. Following is a list of benefits included with each exam:

Diagnostic Lens Fitting– Contact lens eye health evaluation, contact lens design and calculations, additional discussion and education, trial contact lenses and all follow-up visits during the trial period

Vision Guarantee – Any additional contact lens vision related visits within 3 months of the initial comprehensive exam are included (if a medical problem caused the vision change, this will be discussed and a medical charge will apply). Vision changes after 3 months will require a comprehensive exam in addition to the contact lens exam.

Contact Lens Prescription Guarantee – If your prescription changes for any reason, we will exchange ALL contact lenses purchased from Shamrock for the new prescription (yes, even if the boxes are open). We will also provide free replacements for any damaged or lost contact lenses.

We work with most Vision insurance plans and the fees vary, depending on the type of Contact Lens Exam. Insurances may offer co-pays or discounts for contact lens exams. Contact lens prescriptions are valid for up to 1 year from the date of your contact lens examination.

Contact Lens Exam: $95
Established contact lens wearers not requiring a change in contact lens material/type

Re-Fit Contact Lens Exam: $140
Includes the Contact Lens Exam fee, the re-fit into a new material, lens power or type of contact lens and contact lens follow-up visits

New Wearer Contact Lens Exam and Training: $190
Includes the Contact Lens Exam fee, additional measurements and tests for a new wearer, contact lens follow-up visits and all training sessions

Specialty Contact Lens Exam: Varies
These exams require significant time and professional judgement so fees vary

When you are ready to order Contact Lenses

We carry some contact lenses in stock for your convenience and many contact lenses have annual supply rebates. We are competitively priced and provide exceptional service. You can order directly on our website or call/text us at 614-889-8331 to order your contact lenses. All orders are shipped directly to you FREE.

Payment Options

Shamrock Family Eye Care is happy to provide multiple payment options to meet the needs of our patients.

We accept all major credit cards including:

We also proudly accept payments with:

Frequently Asked Questions About Insurance

Can I use my medical insurance to pay for my comprehensive eye exam?

Medical insurance will typically pay for medical eye services, assuming you have an associated medical complaint (ie pink eye, dry eye, allergies, diabetes, high blood pressure, etc). Approved medical testing will often require a specialist copay. If vision correction is required and prescribed during the same visit, a refraction copay will likely be required.

Do you know what eye health and vision issues my insurance will cover? Does my insurance cover vision?

Your insurance is a legal contract between you, your employer, and the insurance company. Because of the number of insurance companies and policies, we cannot be familiar with the eye care limits and exclusions of every plan. It is your responsibility to be familiar with your vision coverage and policy. We are not responsible for any uncovered eye care services performed in this office. If you are concerned about whether or not vision is covered by your policy, it is best to call your insurance company in advance to confirm coverage.

If I need to file my own insurance for eye care services, what do I have to pay at the time of my visit?

We require that you pay any co-payments at the time of your visit. When we receive payment from your insurance company, our office will reconcile the account. Once reconciled, Shamrock Family Eye Care will bill you for the remaining amount due or refund any overage.

What if my insurance reimburses me directly for my medical bills?

There are insurances where, due to contractual arrangements imposed by your insurance company, we may be unable to receive payment directly from the insurance company. In that event, we will ask you to pay for the eye care services in full, with your insurance reimbursement sent directly to you.

How many different insurance companies will you file with?

If you have coverage for the same eye procedure with more than one company, we will file the primary carrier only for direct reimbursement to us. You may file the others for your reimbursement.

Will you file my coinsurance?

Any secondary insurance plans not forwarded directly by your insurance company (such as Medicare) are your responsibility.

Can you get approval from my primary care doctor at the time of my appointment?

Any prior approvals for eye care services or referrals from other doctors must be received before services are rendered.

What if my insurance company has not paid and I start getting bills?

Within three months of filing any insurance, all unpaid balances will become your responsibility. You may then contact your insurance company for reimbursement.