For purposes of this part, a proper optometrist–patient relationship at a minimum requires that:

1. (1) For the purposes of this part, a proper optometrist–patient relationship is deemed to exist in the following situations:

   1. (A) Performs a history and an in-person physical examination of the patient adequate to establish a diagnosis and identify underlying conditions and/or contraindications to the treatment recommended/provided; or
   2. (B) When treatment is provided in consultation with, or upon referral by, another optometrist who has an ongoing relationship with the patient and who has agreed to supervise the patient’s treatment, including follow-up care and the use of any prescribed medications;
   3. (C) On-call or cross-coverage situations arranged by the patient’s treating optometrist;
   4. (D) The optometrist personally knows the patient and the patient’s general health status through an ongoing personal or professional relationship;
2. (2) Appropriate follow-up be provided or arranged, when necessary, at medically necessary intervals;

3. (3)

   1. (A) An optometrist–patient relationship must be established before the delivery of service via tele-optometry.
   2. (B) A patient completing an optometric history online and forwarding it to an optometrist is not sufficient to establish the relationship, nor does it qualify as store-and-forward technology; and

4. (4) The following requirements apply to all services provided by optometrists using tele-optometry:

   1. (A) The practice of optometry via tele-optometry shall be held to the same standards of care as traditional in-person encounters;
   2. (B) The optometrist must obtain a detailed explanation of the patient’s complaint from the patient or the patient’s treating optometrist;
   3. (C) If a decision is made to provide treatment, the optometrist must agree to accept responsibility for the care of the patient;
   4. (D) If follow-up care is indicated, the optometrist must agree to provide or arrange for such follow-up care;
   5. (E) An optometrist using tele-optometry may not issue a prescription for any controlled substances defined as any scheduled medication under Schedules II through V unless the optometrist has seen the patient for an in-person exam or unless a relationship exists through consultation or referral/on-call or cross-coverage situations or through an ongoing personal or professional relationship;
   6. (F) The optometrist must keep a documented patient record;

   7. (G)

      1. (i) At the patient’s request, the optometrist must make available to the patient an electronic or hardcopy version of the patient’s optometric record documenting the encounter.
      2. (ii) Additionally, unless the patient declines to consent, the optometrist must forward a copy of the record of the encounter to the patient’s regular treating optometrist if that optometrist is not the same one delivering the service via tele-optometry;
   8. (H) Services must be delivered in a transparent manner, including providing access to information identifying the optometrist in advance of the encounter, with licensure and board certifications, as well as patient financial responsibilities;

   9. (I)

      1. (i) If the patient, at the recommendation of the optometrist, needs to be seen in person for their current optometric issue, the optometrist must:

         1. (a) (a) Arrange to see the patient in person; or
         2. (b) (b) Direct the patient to their regular treating optometrist or other appropriate provider if the patient does not have a treating optometrist.
      2. (ii) Such recommendation shall be documented in the patient’s optometric record;
   10. (J) Optometrists who deliver services through tele-optometry must establish protocols for referrals for emergency services; and
   11. (K) All optometrists providing care via tele-optometry to a patient located within the State of Arkansas shall be licensed to practice optometry in the State of Arkansas.