Take a photo of your paper prescription and your contacts will ship faster!
Enter your prescription. This can be found on the side of your box.
Enter the details of prescribing doctor
Date Required
Expiration Date Required
Doctor Name Required
Please enter valid Doctor Name
License Required
Phone Required
Fax Required
Address Required
Please enter valid Spherical Power (SPH) value
Please enter valid Cylinder Power (CYL) value
Please enter valid AXIS value
Please enter valid Spherical Power value
Please enter valid Cylinder Power value
Please enter valid Pupillary Distance value
Note: If you do not have prescription, then write 0.00 in sphere, cylinder and 0 in axis.
Please enter Brand Name
Please enter valid Base Curve value
Please enter valid Diameter (DM) value
Please enter Base valid Curve value
Please enter valid Diameter value
$19.95
