Order Contact Lenses Order your contact lensesPlease enable JavaScript in your browser to complete this form.Name *FirstLastEmail *Telephone *Address *Address Line 1Address Line 2CityState / Province / RegionPostal CodeBrand *Acuvue Air OptixProclearType of lenses *Oasys 1-dayOasys 1-day for astigmatismMoist 1-dayMoist 1-day for astigmatism Moist MultifocalOasys (2 week replacement))Oasys for astigmatism (2 week replacement)Vita (remplacement 1 mois)Vita for astigmatism (1 month replacement)Type of lenses *Air Optix Aqua Air Optix Night & Day Air Optix for Astigmatism Type of lenses *Proclear ToricProclear MultifocalRx Right *Rx Left *Base Curve (B.C.)Quantity *6 months1 year3 months90 days (if same Rx both eyes)Quantity *6 months1 year3 months1 monthQuantity *6 months1 year3 months1 monthQuantity *6 months1 year3 months1 monthQuantity *6 months1 yearQuantity *6 months1 yearQuantity *6 months1 yearComment *Please note that you can only use this form if you already have a contact lens file at our clinic. All other orders will be voided. Please let us know preferred method of payment.Credit Card field is disabled, Stripe payments are not enabled in the form settings.Total *$ 0.00Payment by Interac bank transfer or credit card over the phone. Please mention preferred mode of payment in Comment section. MessageSubmit