Close-up of a person's blue eye, showing detailed iris and eyelashes.

Contact Lenses

Order Contact Lenses

Thank you for supporting local business! We would be glad to place the order for your contact lenses. Please kindly fill out this form and one of our staff member's will reach out to you shortly.

We would like to remind you that if your prescription has expired for over one year, you will need to schedule an eye exam in order to obtain a new prescription.
We accept many insurance plans including VSP, EyeMed, and Davis Vision. Call our office to see if we accept your plan.

Click here to schedule an appointment with our practice

Patient Name

First Name

Last Name

Phone

(###)

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Patient Type

New Patient

Existing Patient

How Many Contacts Do You Need

1 Year Supply

6 Months Supply

3 Months Supply

Would You Like To

Pick Them Up

Ship Them

Address Where You'd Like Them Shipped

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country