Contact Lenses Fill in the form below to order your contact lenses online. Please enable JavaScript in your browser to complete this form.LayoutYour Name *Your Phone NumberYour Surname *Your Email *Current Client?YesNoLayoutI am in possession of a valid prescription *YesNoPlease note it may not be older than 12 months.Upload Prescription Click or drag a file to this area to upload. RIGHT LENSBrand & BCPrescriptionHow many boxes?LEFT LENSBrand & BCPrescriptionHow many boxes?How will you be paying for the contact lenses?Medical AidCash/Credit CardAdditional comments *I agree to the Privacy Policy of this website *I agreeRead Privacy Policy HereSubmit Order
