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Place Your Online Order

On-Line ordering of contact lenses is currently available only for our existing patients.

Please fill in the form below and we will contact you – we can make arrangements for payment over the telephone.

    Your Name (required)

    Your Email (required)

    Subject

    Phone

    Address

    Phone

    Postal Code

    Province

    Lens Information:

    Left EyeRight Eye

    Number of Disposable Lens Boxes Right Eye

    Number of Disposable Lens Boxes Left Eye

    Number of Conventional lenses/Lenses/Hard/Gas Permeable Lenses Right Eye

    Number of Conventional lenses/Lenses/Hard/Gas Permeable Lenses Left Eye

    Additional Information