You will receive a stock supply of requisition forms to keep on hand. These forms are specific to your company and will come pre-printed with your company name on them. You can authorize the forms to your employees on a case by case basis.
On the reverse side of the form, it will outline the benefit criteria, letting both the employee and the dispensing office know what’s allowable and covered under your benefit plan.
The form has all the fields necessary for your employee to order a pair of Rx safety eyewear at one of our Participating ECPs.
HOW IT WORKS
Fill out the top half of the form, including basic employee information and any comments that may be applicable to that job.
Supply the form to the employee. They will take this form into their choice of participating optical locations. The employee must present this form to order their safety eyewear.
When the glasses are ready for pickup, the optician will contact the employee.