© 2016 optometryatcooroy Cooroy Optometrists All Rights Reserved
62 Maple Street
Cooroy Qld 4563
Ph: 07 5442 5555
These questionnaires in PDF format are designed to be filled out by new patients.
By printing and filling out the relevant form/s before your or your child’s examination you will have time to consider your answers and check relevant details. This will allow us to spend even more time with you during the consultatation.
Please bring with you to the appointment or email or fax (5442 5740) beforehand.
Welcome to our Practice -
Welcome to our Practice -
Teachers Questionnaire -
Our comprehensive consultation will take around 45 minutes or possibly longer depending on the number and complexity of the tests required to fully evaluate your vision and the health of your eyes.
Should further testing be recommended, such as visual fields evaluation or dilated retinal examination and retinal scanning, either an additional appointment will be arranged for another day or you may be with us a little longer.
An initial examination for your child will include a full binocular vision assessment and an eye health evaluation and we allow around 1 hr for primary school age children and 45 minutes for high school children.
Depending on your child’s needs and age, this initial examination may also include screenings for various conditions such as visual information processing disorders and Meares-
Your Medicare card so that we are able to process your Medicare claim on the spot if you have your bank account details registered with Medicare or have an eftpos card linked to a cheque or savings account.
Your Health Fund card if you have optical cover included, so that we can process your rebate when purchasing glasses or contact lenses.
If you have a Pension, Veterans Affairs or Health Care Card please bring this with you. We are registered to provide services for Veterans Affairs clients and act as an agent for the State Government Spectacle Supply Scheme for pension card holders.
Your current glasses, sunglasses and contact lenses. Also include any ready-
For your child’s appointment please bring with you any reports from other professionals such as teacher, paediatrician or other specialists.
We are able to process your medicare claim on the spot for you just like at your doctors surgery.
To allow us to process your medicare rebate please make sure you have one of the following:
1. Your bank account details registered with Medicare, or
2. Your bank account details with you, or
3. An eftpos card linked to a cheque or savings account into which the rebate can be deposited from Medicare.
We offer pension card holders a 15% discount on consultation fees and extra testing such as retinal imaging and scans.
Patients over 80 yrs of age and under 5 yrs of age are bulk-
As the type of consultation and services required are not always fully known until your examination we can only offer you what we expect your cost to be prior to your visit. We will let you know at the time if extra costs will be incurred.
Please enquire about the expected fees when making an appointment.