To Finalize and/or Order Contact Lenses:

Name

First Name

Last Name

Phone

(###)

###

####

Date of Birth

Check ALL that apply:

Finalize my Rx (provide detailed info below).

Mail me my Rx (provide mailing address below).

Send me my Rx via patient portal along with instructions on how to access the portal.

Contact me via email to order.

Contact me via phone to order.

Mail me my order (provide mailing address below along with # of boxes).

I will pick up my order at EyeJoy.

I have insurance that I will be using for my order.

Other: see my message below.

Message

Use this section to send us any message related to contact lenses, including detailed information about which contact lens trial(s) you want to be finalized in.

What are the perks of purchasing soft contact lens from EyeJoy? If you tear or lose one, we'll replace it easily (we stock 90% of soft contact lens replacement powers for same day pick-up). If you're out of contact lenses and can't get in immediately for an eye exam, we can provide you a complimentary pair so you're not without contacts (Rx on file can't be more than 3 months expired). If your contact lens Rx changes, we'll replace any left over contacts from the previous year's order from us even if the box has been opened. We'll also inform you of any applicable rebates that can only be used for contacts purchased from EyeJoy and these rebates often beat many of the online retailers' rebates. Our rebates can be used in addition to insurance benefits, giving you maximum savings.

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