Order Your Contacts

  • Select the brand of contact lenses you wear.
  • Select your product.
  • Select your contact lens prescription (your prescription is located on the box).
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Patient Name
Right Eye
   
Left Eye
   
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Patient Name/Eye Product SKU Qty Qty Total Remove

** This total excludes any applicable taxes which will be added when your card is charged.

* All rebate programs are created and governed by the contact lens manufacturer. All conditions set forth by the manufacturer must be satisfied in order to receive the rebate. One rebate per patient per 12 month period.

Visit the manufacturer websites to learn more about their rebates Acuvue Rebates | B+L Rebates | Ciba Rebates | CooperVision Rebates

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Shipping Information

*Required Field

*First Name:
*Last Name:
*Address 1:
Address 2:
*City:
*State:
*ZIP Code:
*Phone:
Billing Information

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*First Name:
*Last Name:
*Address 1:
Address 2:
*City:
*State:
*ZIP Code:
*Phone:
Credit Card Details
 
Card Type:
Name as it appears on card:
Number:
Verification #:
Expiration:

Please enter both a first and a last name for 'Patient Name'.

Please select a brand to add an item to the order.

Please select a product to add an item to the order.

Please select a base curve to add an item to the order.

Please select a diameter to add an item to the order.

Please select a sphere to add an item to the order.

Please select a cylinder to add an item to the order.

Please select a axis to add an item to the order.

Please select a 'Add' to add an item to the order.

Please add an item to the order.

All item quantities must be greater than '0' in the order.

Please select shipping.

Please enter a value in the quantity field.

Information for the right eye already exists.

If you wish to change the current product chosen for the right eye:

First, remove the current product for the right eye from the shopping cart.

Second, add the new product chosen for the right eye.

Information for the left eye already exists.

If you wish to change the current product chosen for the left eye:

First, remove the current product for the left eye from the shopping cart.

Second, add the new product chosen for the left eye.

Information for both eyes already exists.

If you wish to change the current product chosen for both eyes:

First, remove the current product for both eyes from the shopping cart.

Second, add the new product chosen for both eyes.

Please select a brand, product and parameters to add an item to the order.

Please select a product and parameters to add an item to the order.

Please select parameters to add an item to the order.

Please enter your first name in the shipping area

Please enter your last name in the shipping area

Please enter your street address in the shipping area

Please enter your city in the shipping area

Please enter your state in the shipping area

Please enter your zip code in the shipping area

Please enter your complete phone number in the shipping area

Please enter your first name in the billing area

Please enter your last name in the billing area

Please enter your street address in the billing area

Please enter your city in the billing area

Please enter your state in the billing area

Please enter your zip code in the billing area

Please enter your complete phone number in the billing area

Please enter your credit card type in the credit card area

Please enter your credit card number in the credit card area

Please enter your credit card verification in the credit card area

Please enter your credit card expiration month in the credit card area

Please enter your credit card expiration year in the credit card area

Please enter your name as it appears on your credit card in the credit card area

To help your doctor and staff identify your order, Please enter the Date of birth for the person this account belongs to in the field provided.