Company:
Attn:
Address:

City:
State:
          Zipcode:

Phone:
Fax No:
Email Address:
Please send information about the following program(s):
To order information on the Outlook Vision program,  please complete the information below and click the "submit" button, or call us at 800-342-7188.
Number of Employees or Members:
PLAN WILL BE:
© 2012  Outlook Vision Services, LLC   All Rights Reserved
Website by Virtual Web Solutions
DISCLAIMER
This program is not insurance. It is a discount program. You are responsible for the full cost of any health care services purchased. You will receive discounts for medical services at certain health care providers who have contracted with the program. Members have the right to cancel registration at any time. Cancellations within 30 days will receive a refund of membership fees. This program does not make payments directly to health care providers. A list of all program providers within the prospective cardholder’s service area which includes their name, city & state, and medical specialty is available prior to purchase, upon request. Discounts for hospital services are not available. This program is administered by Access One Consumer Health, your Discount Medical Plan Organization, 84 Villa Rd., Greenville, SC 29615 - www.accessonedmpo.com. The program and its administrators have no liability for providing or guaranteeing service or the quality of service rendered. Not available in AK, CT, MT, RI, VT & WA.
Please send the following package(s):
Employer Group Package
Association Package
Outlook Vision
Outlook Prescription Rx Card
Employer Paid
Employee Paid