Lake Country Optometry Clinic, optometrists in Lake Country BC

Contact Lens Order Form

mandatory fields *

Title:
* Full name:
* Date of birth:
* Day time telephone:
* E-mail:	(for confirmation email only, will not be given to a third party)
* Type of lenses required:	Name of product: Right Eye Left Eye Quantity: 1 year 6 months 3 months OR Number of boxes:
Name of your optometrist:
Comments:

Don’t forget about solution! If you purchase your solution at the same time as your contact lenses then you save the GST and PST! Not all solutions are the same and some solutions can react negatively with certain contact lenses. You should always use the same solution and ensure that you are using the solution recommended by your optometrist. Just ask us to add it to your order when you come to pick up your lenses!