Checklist template

Contact lens services for optical stores

A ready-to-use checklist with 103 items in 6 sections, covering Fitting, Trial lenses, Insertion training, Prescription verification, Ordering, Expiry. Use it as-is in InspectLoop, or adapt it to your own standards in minutes.

  • 6 Sections
  • 103 Items
  • 87 Yes / No checks
  • 6 Scored ratings
  • 117 Points

Use this template How audits work

1. Fitting 18 items

  1. The contact lens fitting fee is explained to the patient before the fitting starts Yes / No 1 pt
  2. Fittings are performed only by persons authorized to fit contact lenses under local regulation Yes / No 1 pt
  3. Keratometry or corneal topography readings are in the record before the first lens is selected Yes / No 1 pt
  4. The patient's wearing goals (full time, occasional, sports) are noted in the record Yes / No 1 pt
  5. Daily, two-week and monthly replacement options are explained with their yearly cost Yes / No 1 pt
  6. Lens centration, movement and coverage observed at the slit lamp are noted for each eye Yes / No 1 pt
  7. The lens is left to settle for the time recommended by the manufacturer before the fit is assessed Yes / No 1 pt
  8. An over-refraction is recorded with the trial lens on the eye Yes / No 1 pt
  9. Rotation of a toric lens is recorded in degrees and direction Yes / No 1 pt
  10. Multifocal fits are checked with both eyes open in normal room lighting at distance and near Yes / No 1 pt
  11. The wearing schedule is written in the record Yes / No 1 pt
  12. The replacement schedule is written in the record Yes / No 1 pt
  13. A follow-up visit is booked before the patient leaves with trial lenses Yes / No 1 pt
  14. The prescription is finalized only after the follow-up visit confirms the fit Yes / No 1 pt
  15. The final record gives brand, base curve, diameter and power for each eye Yes / No 1 pt
  16. The patient receives a copy of the contact lens prescription once the fitting is complete, as required by local regulation Yes / No 1 pt
  17. New contact lens fits completed last month Number
  18. Completeness of 5 fitting records sampled Rating
    • All complete 5 pts
    • 1 record with missing fit notes 3 pts
    • 2 or more incomplete 1 pt

2. Trial lenses 17 items

  1. Soft trial lenses are filed by brand, then by power, in labeled drawers or racks Yes / No 1 pt
  2. Toric trial lenses are filed by cylinder and axis within each brand Yes / No 1 pt
  3. Each fitting set of a brand the store prescribes holds its core power range without gaps Yes / No 1 pt
  4. Missing powers are listed and reordered from the manufacturer on a set schedule Yes / No 1 pt
  5. Date of the last trial lens replenishment Date
  6. Trial lenses are stored apart from boxes held for sale Yes / No 1 pt
  7. Each trial lens given to a patient is entered in the patient record with brand and parameters Yes / No 1 pt
  8. Trial lenses are given only to patients with a fitting in progress or a valid prescription Yes / No 1 pt
  9. The number of trial pairs given to one patient stays within the limit set by company policy Yes / No 1 pt
  10. Fitting sets of discontinued brands have been removed Yes / No 1 pt
  11. The manufacturer's current fitting guide is kept with the fitting set of each brand Yes / No 1 pt
  12. An inventory list identifies each reusable rigid or scleral diagnostic lens by its parameters Yes / No 1 pt
  13. Every lens on the rigid diagnostic set list is present in its labeled vial or case Yes / No 1 pt
  14. Starter kits (lens case, travel-size solution) are in stock for new wearers Yes / No 1 pt
  15. Access to trial lens drawers is limited to employees Yes / No 1 pt
  16. Brands of soft lens fitting sets held Number
  17. Organization of the trial lens stock Rating
    • Filed in order, complete range 5 pts
    • Filed in order, several gaps 3 pts
    • Unsorted or powers cannot be found 1 pt

3. Insertion training 21 items

  1. A new wearer leaves with lenses only after inserting and removing them without help the number of times set by company policy Yes / No 1 pt
  2. Training takes place at a table with a mirror, a sink nearby and lint-free towels Yes / No 1 pt
  3. Training is booked as its own appointment slot Yes / No 1 pt
  4. The trainer asks the patient to wash and dry hands before touching a lens Yes / No 1 pt
  5. The trainer shows how to tell whether a lens is inside out Yes / No 1 pt
  6. The trainer shows how to inspect a lens for tears before insertion Yes / No 1 pt
  7. The patient is taught to rub and rinse reusable lenses with the solution named in the record Yes / No 1 pt
  8. The patient is told never to use tap water or saliva on lenses or the case Yes / No 1 pt
  9. The patient is told to empty the case, rinse it with solution and leave it open to air dry Yes / No 1 pt
  10. The patient is told to replace the lens case at the interval stated on the care sheet Yes / No 1 pt
  11. The wearing time build-up for the first week is written down for the patient Yes / No 1 pt
  12. The patient is told not to sleep in lenses unless extended wear was prescribed Yes / No 1 pt
  13. The patient is told to remove lenses before swimming or showering Yes / No 1 pt
  14. The patient is told to remove lenses and call the store if an eye becomes red, painful or blurred Yes / No 1 pt
  15. A written care sheet is given to the patient Yes / No 1 pt
  16. The patient signs an acknowledgment of the care instructions, kept in the record Yes / No 1 pt
  17. An after-hours contact number for eye emergencies is printed on the care sheet Yes / No 1 pt
  18. New wearers are told to keep a pair of glasses with a current prescription Yes / No 1 pt
  19. A training record is on file for each employee who teaches insertion and removal Yes / No 1 pt
  20. Minutes scheduled for a new wearer training appointment Number
  21. Training session observed or described by the trainer Rating
    • Hygiene, handling, care and warning signs all covered 5 pts
    • One topic missed 3 pts
    • Patient released without showing insertion and removal 1 pt

4. Prescription verification 15 items

  1. Contact lenses are sold only against a contact lens prescription that has not expired Yes / No 1 pt
  2. The prescription expiry date is checked at every reorder, including phone and online reorders Yes / No 1 pt
  3. For an outside prescription, a copy is on file or the prescription was verified with the prescriber Yes / No 1 pt
  4. Verification requests sent to outside prescribers are logged with the date and time sent Yes / No 1 pt
  5. An order is released only after the prescriber confirms or the verification period set by local regulation has passed Yes / No 1 pt
  6. Verification requests received from other sellers are answered within the time allowed by local regulation Yes / No 1 pt
  7. Incoming verification requests are logged with the answer given Yes / No 1 pt
  8. No brand is substituted without the prescriber's approval Yes / No 1 pt
  9. Lenses dispensed match the prescription for base curve, diameter, power, cylinder, axis and add Yes / No 1 pt
  10. The quantity sold does not exceed what the prescription's remaining validity allows under company policy Yes / No 1 pt
  11. Patients with an expired prescription are offered an exam appointment Yes / No 1 pt
  12. Colored and cosmetic lenses without power are sold only against a prescription Yes / No 1 pt
  13. A copy of the prescription is released to the patient or a designated agent on request Yes / No 1 pt
  14. Sales without a valid prescription on file in a sample of 5 recent sales Number
  15. Prescription control in the 5 sales sampled Rating
    • Valid prescription behind every sale 5 pts
    • Prescription valid but not on file for 1 sale 3 pts
    • Any sale on an expired or missing prescription 1 pt

5. Ordering 16 items

  1. An annual supply is quoted to every patient, with the per-box price Yes / No 1 pt
  2. Manufacturer rebate instructions are given with qualifying purchases Yes / No 1 pt
  3. The contact lens allowance of the patient's benefit plan is applied to the order Yes / No 1 pt
  4. The order is entered with right and left eye parameters on separate lines Yes / No 1 pt
  5. Direct-to-home shipping is offered Yes / No 1 pt
  6. The shipping address is confirmed with the patient at each direct shipment Yes / No 1 pt
  7. Orders are sent to the distributor on the day they are taken Yes / No 1 pt
  8. Boxes received are checked against the order for brand, base curve, power and quantity before the patient is called Yes / No 1 pt
  9. Boxes are marked right and left where the two eyes differ Yes / No 1 pt
  10. Each order is bagged with the patient's name Yes / No 1 pt
  11. Patients are notified on the day their order arrives Yes / No 1 pt
  12. Contact lens orders waiting for pickup for more than 30 days Number
  13. Patients with a backordered lens are told the expected date Yes / No 1 pt
  14. Unopened boxes returned by patients are sent back to the distributor for credit within the return window Yes / No 1 pt
  15. Reorder reminders are sent to patients before their supply runs out Yes / No 1 pt
  16. Handling of contact lens orders Rating
    • Same-day ordering, checked on receipt, patient notified 5 pts
    • One step inconsistent 3 pts
    • Orders delayed or not checked 1 pt

6. Expiry 16 items

  1. Expiry dates of trial lenses are checked monthly Yes / No 1 pt
  2. The monthly expiry check is recorded with the date and initials Yes / No 1 pt
  3. Date of the last expiry check of trial lenses Date
  4. Expired lenses found in a sample of 20 trial blisters Number
  5. Trial lenses expiring within the window set by company policy are marked or pulled Yes / No 1 pt
  6. Boxes held for sale are rotated so the earliest expiry is sold first Yes / No 1 pt
  7. Boxes sold as an annual supply have an expiry date beyond the supply period Yes / No 1 pt
  8. Lens care solutions on the retail shelf are in date Yes / No 1 pt
  9. Starter kit solutions are in date Yes / No 1 pt
  10. Expired lenses are removed and recorded before disposal or return to the manufacturer Yes / No 1 pt
  11. Lens cases given to patients are in sealed packaging Yes / No 1 pt
  12. Manufacturer recall notices are compared with the lot numbers in stock Yes / No 1 pt
  13. Recall notices are filed with the action taken Yes / No 1 pt
  14. Name of the person responsible for contact lens stock Short text
  15. Overall contact lens service Rating
    • Strong 5 pts
    • Acceptable 3 pts
    • Weak 1 pt
  16. Corrective actions required Comments

About this template

This checklist is part of the InspectLoop template library. Yes / No checks score 1 point when met; ratings score the points shown for each option. The overall score is the percentage of points earned, with N/A answers excluded. In InspectLoop you can add photos, assign corrective actions, require sign-off and compare results across sites.

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