Luminous Optometry Membership Plan – Terms & Conditions

---

• The Luminous Optometry Membership Plan (“Plan”) is an in-house savings program for vision care services and eyewear provided at Luminous Optometry.
• This Plan is NOT insurance and cannot be combined with vision or medical insurance.
• Membership provides discounts on select services and products for 12 months from the enrollment date.

• Available to individuals and families who receive services at Luminous Optometry.
• Membership fees are non-refundable and must be paid in full at the time of enrollment.

Membership automatically expires after 12 months unless renewed.

• One (1) Comprehensive Eye Exam per year (includes refraction & eye health evaluation).
• 15% OFF Optical Frames/Sunglasses Frames
• 15% OFF Premium Lenses Options
• 20% OFF Contact Lens Exams
• 10% OFF Contact Lenses Order & Specialty Services (Dry Eye Treatment, Myopia Control, etc.)
• Free shipping on Contact Lenses supply. 
• Priority Scheduling – Get seen faster with VIP appointment access

• The Plan does not cover medical eye exams (e.g., red eye visits, glaucoma management, diabetic eye exams).
• Discounts do not apply to already discounted packages, promotions, or special sales.
• Cannot be used in conjunction with insurance, flexible spending accounts (FSA), or health savings accounts (HSA) for services/products that insurance could cover.

Membership benefits are non-transferable and cannot be shared with individuals outside the enrolled household.

• Membership fees must be paid upfront; no payment plans are available.
• Membership is non-refundable even if benefits are unused.
• If a member misses an appointment without proper notice, standard no-show fees may apply.

By signing below, I acknowledge that I have read, understood, and agree to the terms and conditions of the Luminous Optometry Membership Plan. I understand that this is a discount program, not insurance, and that membership fees are non-refundable.

Patient Name: ____________________________
Date of Birth: ____________________________
Phone Number: ____________________________
Email Address: ____________________________

Signature: ____________________________
Date: ____________________________

• The Luminous Optometry Membership Plan is not a qualified health plan under the Affordable Care Act (ACA) and does not meet any insurance requirements.
• Membership fees cannot be submitted to insurance for reimbursement.
• Luminous Optometry reserves the right to modify pricing or benefits with written notice before the renewal period.
• Membership does not guarantee appointment availability and is subject to office scheduling policies.