1.   Difference Between Vision Screening & Eye Exam
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2.   Parent FAQ's
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3.   Career Opportunities
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4.   Gift of Sight Program
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5.   Patient Referral
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Contact Lens Reorder Form

Note: You must fill in all the required fields

First Name:      Last Name:

Email Address:

Daytime phone number(cellphone preferred):

Pick-up Options:      OR     
Address:
Province/State:
City:
Postal/Zip:  
Country:

We will use your current prescription for the order.
You will be contacted if your current prescription is no longer valid.


Solution:    Quantity:  

Eye Drops:    Quantity:  

Quantity of boxes of contact lenses:  

Additional Comments: (Optional)


Human test:

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