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Order Contact Lenses
It is easy!
*
Indicates required field
Patient's Name (First - Last)
*
Birthday
*
Email
*
Phone Number
*
How Many Boxes
*
1 Month Supply
3 Months Supply
6 Month Supply
1 Year Supply
Using Insurance Benefits ?
*
Yes
No
Don't Know (please check)
Payment Options (we will contact you with the total)
*
Use my credit card on file
Pay over the phone
Pay online
Comment
*
Submit
HOME
OFFICE INFO
SERVICES
REVIEWS
MEET US
CONTACT US
SCHEDULE ONLINE
PAY - ORDER ONLINE