Once we receive your request, we will then contact you to confirm your order, prescription information, and method of payment.
We do not ask for any payment information on this form. After we receive your request, we will contact you by phone for your payment information.
If this form does not fit your request or you would prefer to contact us by phone or fax instead - all of our contact information can be found here. Thank you
Our certified technicians: Julie, Debbie, Susie, and Maribeth, will assist with your contact lens order.
