Improve Eyesight with RevitalVision

RevitalVision LLC · 1617 St. Andrews Suite 210 · Lawrence, Kansas 66047 www.RevitalVision.com
1RevitalVision in Your Practice
RevitalVision
in Your Practice

What is RevitalVision?
• RevitalVision represents a new category in
vision improvement
• Non-invasive technology that enhances
eyesight neurologically
• Average improvement of:
• 2 lines visual acuity
• 100% in contrast sensitivity

Program Facts
About the program:
• Completed on a computer, at the patient’s convenience,
two to three times per week
• Each of the 20 sessions takes an average of 20 minutes*
• Customized to the patient’s pace and visual ability
• Professionally monitored by a
RevitalVision™ Personal Vision Specialist
*Amblyopia therapy is approximately 40, 40 minute sessions
Personal Vision Specialist

Program Facts
• Gabor Patches were developed
by two Nobel Prize winners,
specifically physicist,
Dennis Gabor.
• Widely used in the field of visual
neuroscience. Gabor patches
represent the most effective
stimulation of the primary visual
cortex
• Presented in a “game” format
of choices
• Each series of visual tasks is
customized to every patient’s
visual ability.

RevitalVision Treatment Process
exam form
BASELINEEXAMFOLLOW-UPEXAM
FAX FORM TO: 1.877.856.9818
FOLLOWING COMPLETION, FAX FORM TO: 1.877.856.9818
1617 St. Andrews Drive ▪ Lawrence, Kan. 66047 ▪ (p) 866.954.1619 ▪ (f) 877.856.9818 ▪ www.revitalvision.com
EXAM FORM
Patient Name: ______________________________________ Email Address: _________________________________________
Ship to Address: _________________________________Best Contact Phone (home or cell): ____________________________
City: ______________________________________________ Best Time to Call: ______________________________________
State: ________________________ Zip: ______________ Date of Birth: ___/___/____ Examination Date: ___/___/_____
Gender:  Male  Female
The patient would like to improve (Rank in order 1 = Most important, 4 = least important)
___ Improve Near Vision ___ Improve Far Vision ___ Improve Intermediate Vision ____ Better Overall Vision
PRACTICE NAME/LABEL (required):
Presbyopic  Yes  No Monovision  Yes  No Corrective Eyewear  Yes  No
Distance Eye:  OD  OS
Patient Surgery History
Refractive Surgery  Yes  No Date ___________ DSAEK  Yes  No Date ___________
__OD __OS __OU __OD __OS __OU
Cataract Surgery  Yes  No Date ___________ Lens Type _____________________________
__OD __OS __OU
Unaided Distance VA Unaided Near VA
VA
OD
OS
VA
OD
OS
Manifest Subjective Refraction
SPH CYL AXIS Distance VA ADD Near VA
OD
OS
Present Rx  Glasses  Contact Lenses  Contact Lenses/Monovision
Best Corrected Best Corrected
Distance VA ADD Near VA
VA
OD
OS
VA
OD
OS
Examination Date: ___/___/_____
Doctor Name _________________________________________ Signature_____________________________________

Suggested Retail: $495
Cost to Practice: $250
• No upfront costs. RevitalVision bills practices
on 30-day cycle.
• RevitalVision ships product directly to patients’
home. Practices do not have to carry inventory.
Products and Pricing

Practice and Patient Benefits
• For ALL patients wanting BRIGHTER, CRISPER,
SHARPER vision
• Promote RevitalVision pre-surgery to enhance
surgical outcomes
• RevitalVision can be completed (or sold) anytime, post surgery
• Incorporate RevitalVision in a “premium”
cataract offering
• Innovative and effective tool for:
• Post refractive surgery presbyopes
• Non surgical presbyopes
• Any patient who desires/needs better
contrast sensitivity
• Drusen
• DSAEK
• Early stage AMD
• Little to no disruption to current practice procedures
• As easy as “writing a prescription”

Selling Strategies
Strategy #1
Strategy #2
Strategy #3
Inclusive of Premium Sell
• Included in premium/lifestyle surgical global fee
• Value-added service for differentiation
• Improves patient outcomes
• Improves overall “premium” patient experience
Elective Purchase Opportunity
• Purchase in addition to standard monofocal cataract surgery
• Creates “middle” tier for surgical options
• Value-added service for differentiation
• Can be sold at anytime post-op
Elective Purchase Opportunity
• For non-surgical patients
• Presbyopes
• Low myopes
• Amblyopes
• Sports Vision
• Post refractive

Marketing Tools
Consumer Brochures Demo CD
Posters Eyemaginations
Marketing Material Ordered Here:
http://www.revitalvision.com/Doctors MarketingMaterials/

Before Prescribing
Before prescribing RevitalVision, proper documentation
from your practice is required by RevitalVision. Those
documents are found in this manual and include:
• Practice Integration Sign-Up Form
• Sales Agreement
• HIPPA document
Once RevitalVision receives these documents,
your practice will be recognized as a certified
RevitalVision provider.

Prescribing and Billing
To begin a patient on RevitalVision,
fill out the exam form and fax to
RevitalVision (the fax number is located
on the exam form).
• Your office is responsible for
collecting payment from the
patient, and RevitalVision will bill
you once a month.
exam form
BASELINEEXAMFOLLOW-UPEXAM
FAX FORM TO: 1.877.856.9818
FOLLOWING COMPLETION, FAX FORM TO: 1.877.856.9818
EXAM FORM
Patient Name: ______________________________________ Email Address: _________________________________________
Ship to Address: _________________________________Best Contact Phone (home or cell): ____________________________
City: ______________________________________________ Best Time to Call: ______________________________________
State: ________________________ Zip: ______________ Date of Birth: ___/___/____ Examination Date: ___/___/_____
Gender:  Male  Female
The patient would like to improve (Rank in order 1 = Most important, 4 = least important)
___ Improve Near Vision ___ Improve Far Vision ___ Improve Intermediate Vision ____ Better Overall Vision
PRACTICE NAME/LABEL (required):
Presbyopic  Yes  No Monovision  Yes  No Corrective Eyewear  Yes  No
Distance Eye:  OD  OS
Patient Surgery History
Refractive Surgery  Yes  No Date ___________ DSAEK  Yes  No Date ___________
__OD __OS __OU __OD __OS __OU
Cataract Surgery  Yes  No Date ___________ Lens Type _____________________________
__OD __OS __OU
VA
OD
OS
VA
OD
OS
Manifest Subjective Refraction
SPH CYL AXIS Distance VA ADD Near VA
OD
OS
Present Rx  Glasses  Contact Lenses  Contact Lenses/Monovision
Best Corrected Best Corrected
Distance VA ADD Near VA
VA
OD
OS
VA
OD
OS
Examination Date: ___/___/_____
Doctor Name _________________________________________ Signature_____________________________________

Receiving RevitalVision
After RevitalVision receives the
exam form.
• RevitalVision will ship the product
within 24 hours;
• Your patient will be assigned a
Personal Vision Specialist (PVS) on
your practice’s behalf.
• The PVS will generate a User Name
and Password* for the patient. This
information is provided via email
within 24 hours.
* A User Name and Password are needed for
EACH patient as the program is customized to
that person’s visual ability. Hence, a patient will not
be able to share the program.
Personal Vision Specialist

Beginning RevitalVision
Once the product arrives (usually in
3-5 days), the patient is encouraged by
their PVS to read the User Guide for
program instructions.
Patients install and begin the program.
• Patients are instructed by their
PVS and will handle ALL questions,
eliminating the need for practice
interruption.

Patient Progress Reporting
The PVS monitors the patient’s progress to completion
and sends weekly progress reports to your practice for
each patient.
• A patient is considered compliant when 2-3 sessions
are completed weekly. However, RevitalVision
recommends 3 sessions per week.

Helpful Information
Timeline
Environment
Follow-up
Return Policy
• A patient can begin the program at anytime.
• Post surgical patients can begin one week following surgery.
• Patient sits in darkened room during treatment session.
• Patient must be 5 feet away from monitor during program
(mouse extender provided).
• Follow-up exams are at the discretion of the practice. If a follow-up
exam is given, RevitalVision asks that you return the exam form with
follow-up information, for our records.
• Returns are at the discretion of the practice. RevitalVision
recommends before offering a return the patient complete 10
RevitalVision sessions. If a product is returned, RevitalVision will
credit your practice for that kit.

Contact Information
RevitalVision, LLC
1617 St. Andrews Drive
Lawrence, Kan. 66047
785.856.0417
www.revitalvision.com
info@revitalvision.com

Improve Eyesight with RevitalVision

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