ORDER CONTACT LENSES

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Contact Lens Order Form

Ordering your next supply of contact lenses is just a few clicks away.

Online ordering of contact lens supplies is provided as a service to our current patients only.

We are happy to refill your contact lens order, but your eye health is ALWAYS our priority. Contact lens wearers require annual or bi-annual vision examinations, depending on their health history, to maintain optimal comfort, vision and eye health. To book an appointment with Dr..Anne Baczmanski, please contact our Stratford office or fill out our booking request form

Name

Phone

Which Eye: *

Right Eye

Left Eye

Both Eyes

Supply Amount: *

1 month (only for daily lenses)

3 months (only in daily and bimonthly lenses)

6 Months Supply

1 Year Supply

Lens Solution: *

Yes

Options: *

Call me when my order is ready. I will pick up and pay for them at the office

Deliver my contact lenses to my address. I will phone the office to provide my credit card number. (additional charges will apply)

Special Instructions (if any)

NOTE: You will receive an email confirmation that we have received your order. If you have not heard from us within 2 business days, please call our office.