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Contact Lens Order

Your order has been sent.

We will contact you as soon as your contact lenses are ready for pick-up.

Thank You!

mandatory fields *

  Title: 
* Full name: 
Date of birth:  / /
* Day time telephone: 
* E-mail:  (for confirmation email only, will not be given to a third party)
*  Type of lenses required:  Name of product:  
Right Eye         Left Eye

Quantity:

1 year       6 months      3 months

OR

Number of boxes:

Comments:

Optometric Services Inc. Essilor