1. 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.

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

   1. 1. For ophthalmic lenses other than contact lenses:

      1. a. Name of the patient;
      2. b. Refractive power of the lenses;
      3. c. Printed name, office address, telephone number, and signature of the licensee; and
      4. d. Date of the examination and expiration date of the prescription;

   2. 2. For contact lenses, including plano lenses:

      1. a. Name of the patient;
      2. 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;
      3. c. For a patient who has completed a trial period appropriate under the circumstances for the lenses prescribed, all information necessary to reproduce the contact lenses accurately;
      4. d. Printed name, office address, telephone number, license number, and signature of the licensee;
      5. e. Date of the examination and the issue and expiration date of the prescription; and

      6. f. Information regarding the prescribed contact lenses:

         1. i. Refractive power;
         2. ii. Base curve or other appropriate designation;
         3. iii. Diameter, if appropriate;
         4. iv. Tint, if applicable;
         5. v. Material, manufacturer, or both; and
         6. vi. In the case of private-label contact lenses, manufacturer, trade name, and, if applicable, trade name of equivalent brand name; and

   3. 3. For pharmaceutical agents:

      1. a. Name and address of the patient;
      2. b. Date the prescription is issued;
      3. c. Name, strength, and quantity of the pharmaceutical agent prescribed;
      4. d. Directions for use of the pharmaceutical agent prescribed;
      5. e. Name, office address, and telephone number of the prescribing licensee;
      6. f. When prescribing controlled substances, the DEA number of the prescribing licensee;

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

         1. i. “Dispense as written” under the left signature line, and
         2. ii. “Substitution permissible” under the right signature line; and
      8. h. Original signature of the prescribing licensee on one of the signature lines; and
   4. 4. Additional information that the licensee considers necessary.
3. C. A licensee who dispenses or directs the dispensing of ophthalmic materials shall ensure that a prescription is filled accurately.
4. D. A licensee shall be available to verify that a prescription written 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 dispensed by another provider.

5. E. A licensee shall not:

   1. 1. Require purchase of contact lenses from the prescriber or from another person as a condition of providing a copy of the prescription;
   2. 2. Require a payment in addition to, or as part of, the fee for an eye examination, fitting, and evaluation as a condition of providing a copy of a prescription or verification of a prescription;
   3. 3. Require the patient to sign a waiver or release as a condition of verifying or releasing a prescription.

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). Amended by final rulemaking at 22 A.A.R. 328, effective March 28, 2016 (Supp. 16-1).