Order Replacement Lenses

This form is not secure, and will not accept credit card information.
To order replacement contact lenses over the web, use this form and then press the Submit button below.

To order by phone, call 954.564.2020.
Our hours are:
- Monday, Wednesday, Friday: 9:00am - 5:00pm
- Tuesday and Thursday: 9:00am - 6:00pm
- Alternating Saturdays: 8:00am - 12:00pm.

Our staff will contact you with pricing and availability.
Please fill in the form as completely as possible 
The * indicates required information to properly process your transaction.

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Lenses for new patient   established patient
Quantity * Left Eye Right Eye
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If you are a new patient, please fill in your address information
Street address
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2502 E. Oakland Park, Fort Lauderdale, Florida 33306
954.564.2020

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