Contact Lenses

Contact Lens Order Form

If you are a current patient of Focal Point Comprehensive Vision Care - Canadian laws prohibit FPCVC to sell contact lenses unless you have had your eye health assessed within the last 12 months.

If you are not a current patient of Focal Point Comprehensive Vision Care - Canadian laws require FPCVC to obtain a copy of your contact lens prescription and evaluate your eye health prior to shipping your lenses, if date exceeds 12 months.

Our Licensed Contact Lens Fitter will contact you shortly via email or phone to confirm your last eye health evaluation and order.

* Required Field

First Name*

Last Name*

Address*

City*

Province

Postal Code

Daytime Phone

Mobile Phone

Evening Phone

Email*

Contact Lenses:

On File

Will Fax to 204 822 6740

Call My Doctor

Call My Fitter

Brand

Right eye quantity boxes or vials

Left eye quantity boxes or vials

Solutions Required: (available at reduced price with contact lens orders)

Yes

Solution Brand:

Ship To: (shipping $ may apply)

NOTE: Many manufacturers offer Valuable Rebates on Quantity or Annual Orders greatly reducing your annual cost of supplies, please contact me with possible savings.

Covid-19 Update

Contact Lenses

Contact Lens Order Form