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Order Contacts

* If you are not a patient of ours, we do require a valid prescription before we can place your order. You can fax or e-mail that Information.

* If you would like to have your contacts mailed directly to you, we will need to have payment before we can process your order. Please complete the order form below and then call the office with your credit card information.

* Per Kansas law Contact Lens prescriptions are only valid for one year. If it has been over a year since your last eye exam. Please contact us at 913-299-8800, to set up an appointment.

First Name:*required
Last Name:*required
Street Address:*required
Zip Code:*required
Phone Number:*required
E-mail Address:
Order Verification:
Patient Status:
Contact Lens Name ($ per box)
Right Eye Prescription:*required
Left Eye Prescription:*required
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