RX Verification
Please provide a valid eye prescription slip or contact details from an eye doctor
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Prescription Requirement
According to the Fairness to Contact Lens Consumers Act (FCLCA), we need your valid prescription or eye doctor contact information to verify your eye prescription for the order.
Eight-Business-Hour Verification
According to the Contact Lenses Rule, your prescriber has eight business hours to respond. If there is no response within the required time, your prescription is verified automatically, and we can ship the order to you
Prescription Slip
Your Name *
Date, Prescription Issued *
MM
/
DD
/
YYYY
Date, Prescription Expired *
MM
/
DD
/
YYYY
Optometrist Details
Doctor's Name *
Clinic Name *
Clinic Email *
Clinic Phone Number *
Right Eye (OD) *
Left Eye (OS) *
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