Order Contact Lenses Online

This form is to be used only by current patients of our office with valid contact lens prescriptions on file.

Name
First Last
Phone Number
Email
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Which Eye?
Untitled
Number of Boxes Per Eye
* 1 box per eye = 2 boxes total
* 2 boxes per eye = 4 boxes total
How many boxes per eye?
Number of boxes if other than 1 or 2 boxes per eye
Payment Details
If you will be picking up your order at the office, payment will be accepted at that time. If you would like the order shipped to your home, our office will contact you regarding payment information.
Pick Up/Delivery Options
Untitled
- I will come to the office to pick up order
- Please ship to me (shipping fees apply if less than a year's supply ordered)
Additional Comments/Special Requests

Covid-19 (Coronavirus)

As your eye health care provider, you can trust that we always take health and patient care seriously. The wellness of our associates, our patients, and our community is of the utmost importance to us.

Our practices are temporarily closed to routine patient care from March 19 through April 3rd.

ORDER CONTACT LENSES (this should link to https://www.myeyedr.com/contact-lens-ordering)

through our partner, MYEYEDR.

Order Contact Lenses Online

Which Eye?

Number of Boxes Per Eye

Payment Details

Pick Up/Delivery Options

Ask Here, Voice Search

First Eye Care – Prestonwood