Please complete the information below to place your orderPlease enable JavaScript in your browser to complete this form.Name *Email *Phone number *What brand of contact lenses do you wear? *Right Eye – Number of Boxes *Left Eye – Number of Boxes *Contact Lens Solution *Optifree Replenish Pack (6 mos supply)Clear Care Twin Pack (6 mos supply)No thank you($19.50 and NO HST if ordered with contact lenses)Questions or comments about your orderWebsiteSubmit
