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ORDER CONTACTS 
ANTIME ANYWHERE!

If you’re an existing patient at EyeWorld Optometry Clinic and you’re running low on contacts, you can easily refill your contact lens supply online. Simply fill out the form below to submit your order.

Once your order is placed, you will receive a confirmation email and an invoice. The invoice is payable when you pick up your contact lens order. Please note that your contact lens prescription is valid for one year from the date it is issued. When the current contact lens prescription we have on file for you expires, we will contact you to book a contact lens exam. A valid contact lens prescription is required for online ordering.

 

Contact Lens Order Form

* are required.

Name*

Address*

Date of Birth (YYYY-MM-DD)*

Phone number*

Email Address*

PLEASE INDICATE PRODUCT, QUANTITY AND/OR INSTRUCTIONS FOR YOUR ORDER*

CONTACT LENS BRAND AND NAME

Thank you for your order.  We will contact you shortly to confirm your order detail.

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