Order Contact Lenses
  1. This service is intended for customers who have a current Contact Lens prescription with us.. Please complete your details below:
  2. First Name*
    Please type your full name.
  3. Last Name*
    Please type your full name.
  4. Contact Phone*
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    Please provide your mobile number if you prefer contact by text
  5. E-mail*
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  6. We will order a 6 months supply of your LATEST PRESCRIPTION lenses for EACH eye.
  7. If you require something different please tick "OTHER" and describe what you require in the Other box that opens:
  8. Quantity*
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  9. Other
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  10. Payment Method*
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  11. When would you like to be contacted?*
    Please select a date when we should contact you.
  12. We will advise when your order is ready. How would you like us to contact you?
  13. How should we contact you?
  14. Delivery Method*
    Please specify whether you will pickup your order or would prefer it to be delivered to you
  15. Delivery Address*
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  16. Special Delivery Instructions
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    Any special instructions for your delivery? e.g. Beware of the dog
  17. Antispam*
    Antispam
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    Type the text you see
  18.