(1) A licensed dispensing optician shall establish and maintain a separate, adequate, legible and accurate written service record for each person for whom he or she prepares or dispenses ophthalmic lenses, spectacles, eyeglasses, contact lenses, or appliances related thereto. The record shall be kept in chronological order in the office where the licensed dispensing optician rendered such services, or in the office of the optical goods establishment from which such items were dispensed, if different. Record entries shall be made contemporaneously with the performance of the function or service being documented. Each such entry shall be signed by, or shall otherwise adequately identify, the licensed dispensing optician who provided, or supervised the provision of, that function or service. Such records shall include, at a minimum, documentation of the following:

1. (a) The name, address and telephone number of the person to whom the record pertains;
2. (b) The date on which each function or service documented in the record was performed, and the name and license number of the individual who provided or performed that function or service;
3. (c) All eyeglass prescriptions and contact lens prescriptions presented to the licensed dispensing optician at that location by or for the person to whom the record pertains; and
4. (d) All documentation required by 235 CMR 5.02(2).