Order Contact Lenses

To ensure the health of your eyes with contact lenses, orders online will only be processed if you have had an eye exam with contact lens assessment in the last two years. Verification of your order will be done at our office within two business days and a confirmation of your order will be emailed to you. If we are shipping your order, our staff will call you to obtain payment information.

First Name*
Last Name*
Email Address*
Daytime Phone Number*
(000-000-0000)
Please check the following:*
I will pick up my orderPlease ship the order directly to me (an additional shipping fee may apply)
Address
(Required if shipping requested)
**If we are shipping to your workplace during office hours, please provide a Business Name with address**
Quantity*
Notes

*Service available to QOC patients only