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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.

ORDER FORM

PATIENT NAME
ARE YOU?
HOW MANY CONTACTS DO YOU NEED?
WOULD YOU LIKE TO
THE ADDRESS WHERE YOU NEED US TO SHIP THEM
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.