Order Contact Lenses Online Name* First Last Address* Street Address Address Line 2 City AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Postal Code Phone*Where you can be reached in the next 24 hoursEmail* Payment method*VisaMastercardMy prescription is on record in your office* Yes No Supply needed (months)*3 months6 months12 monthsYou will be called at the number above for payment details by the next business day. A $5/box savings will be applied on 4 boxes or more. All orders are shippped FREE to the address listed above.Questions: