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Please use the form below to re-order your contacts from the comfort of your home. When your contacts arrive at the office, you will be notified. Please indicate in the form below if you would like to be notified by e-mail or phone. Payment is due when you pick up your contact lenses.

If you would prefer to have your contacts sent directly to your home, please call the office with your payment information. Also, there will be an extra charge for delivery.

  * All fields required
   
*Name ::
*Address ::
*City, State, Zip ::
*Country ::
*eMail ::
*Phone ::

Please make your choice from the brands below.
NEW!! Nike   (6 per pack)
Color:  AMBER
$42.00
NEW!! Nike   (6 per pack)
Color:  GREY-GREEN

$42.00
Acuvue Oasys™   (6 per pack) $30.00
Acuvue   (6 per pack) $24.00
Acuvue 2   (6 per pack) $24.00
Acuvue Advance   (6 per pack) $25.00
Acuvue Bifocal   (6 per pack) $45.00
Acuvue Color Enhancers   (6 per pack)
Choose color below
$34.00
Acuvue Color Opaque   (6 per pack)
Choose color below
$36.00
Acuvue Toric   (12 per pack) $72.00
Soflens 38   (6 per pack) $24.00
Soflens 66 Toric   (6 per pack) $38.00
Soflens 66 Multifocal   (6 per pack) $48.00
Other

Please select your color from the choices below. (Not for Nike Colors)
Aquamarine Chestnut Brown Deep Blue Emerald Green Hazel Green Jade Green Ocean Blue Pearl Grey Saphhire Blue Warm Honey

SPECIAL: Buy 4 or more boxes and get a 5% discount!

*Right Eye - Qty :: Boxes
*Left Eye   - Qty :: Boxes

When my contacts are ready for pick up, please notify me by:
E-Mail             Phone

Comments/Questions? ::

 

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