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.Total *$ 0.00Payment by Interac bank transfer or credit card over the phone. Please mention preferred mode of payment in Comment section. MessageSubmit