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ORDER CONTACTS ONLINE « optometryonhydepark.com

Order Contact Lenses

VIP

Please use the form below to order more contact lenses. Your order will be received and processed by our staff and you will receive a confirmation of your order within two (2) business days.

Please be advised it is our office policy that patients must have had a complete eye examination including a contact lens assessment within the past 18 months. It is important to have the  health of your eyes related to your contact lens wear assessed routinely. 

Patient Information:
First name: (required)

Last name: (required)

DOB: (required)

Phone number: (required)

Alternative phone number: (required)

Your Email: (required)

Your name: (if booking for someone else):

Your relationship to Patient:

Type Of Lenses: (required)
 Same as last order
 Latest contacts I am trying
 Other:

Lens Quantity Desired: (required)
 Repeat of last order
 Please send quotes for best value pricing
 Annual supply: See our VIP Contact Lens program
 Other:

Would you like to include a value pack of solution?
 Yes No
Solution Name:

Delivery Method:
 Pick up at Optometry on Hyde Park
 Please ship to the address below* (please use comments section)

Full payment is required prior to shipping of contact lenses.
Our staff will contact you to complete your purchase.

Do you have any comments or questions for us?

*there may be a shipping fee for orders. Remember shipping costs are waived with annual supply – see VIP contact lens program.