U.S. Prescription Upload
For contact lens orders shipped to the United States only. Please provide the name and phone number of the eye care practitioner of the end user OR the prescription of the end user of the order in pdf, doc, docx, jpg, jpeg or png formats. We will verify the information directly with the eye care provider indicated in the uploaded file.
Name
E-mail
Order ID
*
Refer to the order confirmation email or the top of this page.
Your Eye Care Practitioner's Information
E.g. Miami Optometry
E.g. 18008008000
Your EyeCare Practitioner's Info
*
E.g. Miami Optometry
Phone Number
*
E.g. 18008008000
OR
Upload Prescription
Upload a File
Drag and drop files here
Choose a file
Cancel
of
Submit
Should be Empty: