Order form

You can download and print our PDF order form. However, those printable copies don't have any follow up number. Please contact us so we will be able to provide you with a package of numberized ones.

The following are the information that are important to be completed properly when you fill out your order:

• The STYLE of clip-on
• The COLOR of LENSES
• The patient's PRESCRIPTON
• The NAME of the OFFICE