Contact Lens Order Form Would you like to reorder the same lenses, or order the new lenses you are trying?* Please reorder the same brand that I purchased the last time Please order the new lenses that I am trying I am interesed in trying a complimentary pair of new lenses How many boxes of lenses would you like? Remember, you save $$ when you purchase a 1 year supply.* 4 boxes 2 boxes a different supply - see comments section below Would you like to order Contact Lens Solution with your lens supply?* Yes! ......I want to save the solution's tax! (sorry...we do not direct ship solutions) No thanks. Not this time. Name First Last Email PhonePick up/Delivery Options* I will come to the office to pick up my lenses Please ship to my home address - Free shipping! A signature may be required. Please ship to my work address - Free shipping! A signature may be required Shipping Address, if different from home address. Prior to shipping your contacts, we require payment. Please provide your Credit Card information below or call us with this information.