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Reorder Contacts

You may use this online order form to reorder contacts.  Please note that this service is only for existing patients wishing to reorder contact lenses with an existing prescription.  Once we receive the order, we will contact you to validate your order and get a credit card information.  We will contact you when your order arrives.  If you don't feel comfortable entering your information below, please feel free to contact our office at 972-712-1010.

Please note that new order contacts can not be placed until the

patient's account has been paid in full.

 

(Items with * are required in order to submit your request.)
*Name:
*Address:
*City:
*State/Province:
*Zip/Postal Code:
*Home Phone:
Work Phone:
*Email:
*Date Of Birth: / /
*Best Way to Contact:
*Best Time to Contact:
*Doctor's Name:
*# of Boxes for Left Eye:
*# of Boxes for Right Eye:
Comments: