CONTACT ORDERING

Please fill in the fields below to re-order your contacts.

Name:
Birth Date:	/ /
Boxes of Left Lenses:	1 2 3
Boxes of Right Lenses:	1 2 3
	Payment Options: Credit Card/Cash/Check (Pick up in office only)
E-mail:
Daytime phone:
	No state sales tax on orders We will email or call upon receipt of your order to confirm and collect any other necessary information.
Additional Comments:
	Please call 405-329-8100 or email Michelle at michelle@normaneyeassociates.com with any questions.