Forms & Payment

Forms & Payment

At Benchmark Optical, we believe in continual improvement of our services. Please take a few moments and share your experience with our office. We appreciate your feedback!

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Online Forms

Speed up your visit by completing the necessary form(s) below. For your convenience, you can either fax us your printed and completed form(s) or bring it with you to your appointment.

Patient History Form - Download & Print

Insurance Information Form - Download & Print

Payment Options

Benchmark Optical believes in the value of eye care for you and your family.  We have products and pricing to accommodate all budgets.  Our office participates in most insurance programs.  For patients who have little or no vision insurance coverage, flexible payment programs can be arranged. To learn more about our payment options, please call our office directly.

Our office accepts cash, personal checks, and all major debit and credit cards including; Visa, MasterCard, Discover, and American Express.

Don't forget to use your:

  • Flexible Spending Plans
  • Health Savings Accounts (HSA)
  • Medical Savings Accounts (MSA)
  • Cafeteria Plans for most of your eye care needs

All of the above plans can be used for all your eye care and eyewear needs, including eyeglasses, contact lenses, routine office visits and medical office visits.


Insurance

Most insurance plans are accepted at our office.  Since there are so many plans and coverage varies widely, please call us to find out if your plan covers care in our office. Our staff will verify and explain your benefits before your visit, at no charge.

No Insurance

For patients who have little or no vision insurance coverage, flexible payment programs can be arranged. If you have no insurance or do not have vision benefits there is still a way for you to receive the care you need.  To learn more about our payment options, please call our office directly.