Patient Center

Online Forms

Welcome to our patient center! Speed up your visit by completing the necessary forms below. For your convenience, you can download and print the form and bring it with you to your appointment.

New Patient Health History Form (Required)

Download & Print

New Pediatric Patient Health History Form (Required)

Download & Print

Pediatric Exam Parent Tips

Download & Print

RECORDS REQUEST

Please review and complete the attached form for release of records under state and federal guidelines.
 
For all copies of medical records there is a nominal fee in accordance with Chapter 115 of SC state regulations.
 
For continuation of care, a summary letter of your current ocular health and conditions will be provided directly to referring or referred doctors at no charge.  A copy of your current contact lens or glasses prescription will also be provided to you at no charge.
 
Completed forms will be accepted via fax, mail or in person.  Please provide a valid proof of ID with submission and your preferred method of payment and records delivery to include either fax, mail or pick up in person.
 
Please note, email delivery (such as gmail, yahoo etc) of written records is not considered secure and is highly discouraged under the HIPPA privacy laws.  When requesting retinal imaging files, these will be provided via email with interpretation and reports provided along with chosen medical record delivery method.  A flat fee of $5 per retinal image will be applied.
 
Kindly allow up to 30 days for processing and retrieval of records.  Per state & federal guidelines, in the unlikely event records are not able to be processed within 30 days, we will provide a written letter to indicate as such with a one time extension of 30 days per state law.
 
Thank You for being a patient with Monarch Eye Care!

Link regarding Fee: https://www.scstatehouse.gov/code/t44c115.php

Once filled out please return the form via email or in person. We will need some time to process your request, it is estimated to be within 30 days after submission.
 
Records Request Form

We strive to make your experience with us easy and enjoyable, and greatly value your feedback.  If you enjoyed your visit, let everyone know!  Please leave a review on Google.  

If for any reason you were not absolutely pleased with your visit, let us know.  Patient satisfaction is our top priority and given the opportunity we will exceed your expectations.  Contact us directly by completing the Contact Form or give us a call and we will address any concerns immediately.   

Check our NEW Referral Rewards Program

Refer friends and family and co-workers to get additional savings on your next frame purchase! You will receive an extra $5.00 off for every new patient that mentions your name at the time of their appointment. Send more, save more, and start earning rewards. As always, we greatly appreciate your business and referrals!

Participating Insurances

We gladly accept the following insurance plans at our office:

Cigna, Eyemed, Tricare, Davis Vision, Healthy Connections, Blue Choice, Medicaid VSP, Marketplace VSP, Physicians Eyecare Plan, Community Eye Care, Superior Vision, Medicare, United Health Care, Blue Cross Blue Shield, CHAMPSVA, and many more.  (If your plan is not listed, give us a call.  New plans are added often.)

Welcome Tricare Standard, Prime and Reserve Select members! As a preferred provider, you will find us in your My Base Guide or give us a call to schedule your next visit. We know the intricacy’s of Tricare and can assist with prior-authorization for special treatments when needed as well as see you for a yearly eye exam.

As a Blue Cross Blue Shield eye doctor in Summerville we provide total eye care including full diabetic eye exams and dry eye evaluation with treatment to name a few.

Many insurances such as Medicare will cover your visit, allowing for a free eye exam once your deductible has been met. We also offer refractions (the test that gives your eyeglass prescription) during these medical eye exams for a small fee, this is not typically covered by medical insurance.

Copays and coverage will vary based on your specific plan.  Please call our office and our staff will verify and explain your benefits before your visit, at no charge.

Payment Options

Monarch Eye Care has products and pricing to accommodate all budgets for your eye care and eyewear needs, including eyeglasses, contact lenses, routine office visits and medical office visits.

Our Office Accepts

  • Cash
  • All Major Debit and Credit Cards (Visa, MasterCard, and Discover)
  • Flexible Spending Plans
  • Health Savings Accounts (HSA) and Medical Savings Accounts (MSA)
  • CareCredit  *with 6 months no interest

Office Information

  • Monday
  • 9:00am - 5:00pm
  • Tuesday
  • 9:00am - 5:00pm
  • Wednesday
  • 9:00am - 5:00pm
  • Thursday
  • 9:00am - 5:00pm
  • Friday
  • 9:00am - 5:00pm
  • Saturday
  • Closed
  • Sunday
  • Closed
843-821-3121
  • 1101 N. Main St.
  • Suite 304
  • Summerville, SC 29483
Contact us today or visit our appointment request page to find a time that is convenient for you to see us.
chatbot icon
chatbot icon

How can we help you today?

Request an Appointment 
Contact Us
View Office Hours
View Patient Forms
 Back

Monarch Eye Care

  • 1101 N. Main St.
  • Suite 304
  • Summerville, SC 29483
843-821-3121
Contact Page Request an Appointment 
 Back

Office Hours

  • Monday
  • 9:00am - 5:00pm
  • Tuesday
  • 9:00am - 5:00pm
  • Wednesday
  • 9:00am - 5:00pm
  • Thursday
  • 9:00am - 5:00pm
  • Friday
  • 9:00am - 5:00pm
  • Saturday
  • Closed
  • Sunday
  • Closed
Request an Appointment