Order Contacts

To request a contact lens order, please supply the following information. Note: the order is not final until you receive a confirmation email from our office. Contact lens orders typically take 1 business day to process.

First Name

Last Name

Email Address

Phone

Delivery options: Delivery options: In-office Pickup Ship to me

Street Address

City

State

Zip Code

Are you using insurance for this order?

How would you like to order?

Number of boxes

# of boxes for Left Eye

# of boxes for Right Eye

Additional Comments