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Contact lens order form template

Contact lens order form template 2026

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The document is a CUSTOM LENS ORDER SPECIFICATION FORM used for placing orders for various types of contact lenses, including new and exchange orders for both gas permeable (GP) and soft lenses. It collects essential information such as account details, patient information, shipping preferences, lens specifications, and additional notes. The form also provides contact information for consultation and order placement.

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Click ‘Get Form’ to open the contact lens order form in the editor.
Begin by entering your Account Name and Account Number at the top of the form. This information is essential for processing your order.
Fill in the Contact Person's name and Order Date to ensure accurate communication regarding your order.
Provide the Patient's Name, including both Last and First names, to identify who the lenses are for.
Select where you want the completed lens order shipped: either to the Office or directly to the Patient. Fill in their shipping address details accordingly.
Choose a Shipping Method that suits your needs, such as 1st Class Mail or Overnight, and provide any necessary details like Zip Code and Phone Number.
Indicate the ORDER TYPE by selecting from options like New GP Lens or Soft Lens Exchange. Be sure to include any relevant Invoice Numbers if applicable.
Complete additional specifications for GP Lens Orders or Intelliwave Soft Lens Orders as needed, ensuring all measurements are accurate.
Use the NOTES section for any special instructions or additional information that may assist in processing your order effectively.

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Versions	Form popularity	Fillable & printable
2021	4.9 Satisfied (37 Votes)
2011	4 Satisfied (34 Votes)

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Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

How do I know what contacts to order?

Choosing Contact Lenses Determine How Often Youll Wear Them. With the Help of Your Optometrist, Decide on A Wear Form. Consider Your Desired Maintenance Level. Think About Your Eye Sensitivity. Consider the Cost. Assess Your Prescription. Decide If You Want Any Special Features. Consult with Your Optometrist.

Can I use my glasses prescription to order contact lenses?

The measurements from one eye test are not compatible with the other. So, is the prescription for contacts the same as glasses? The answer is NO because you need to have 2 separate eye tests, which will result in 2 different prescriptions.

What is the 4 to 1 rule for contact lenses?

This sensitivity phenomenon gave rise to the 4:1 rule, which states that the best candidates for soft toric contact lenses are patients with a sphere to cylinder power ratio of 4:1 (e.g., -4.00 -1.00 x 090).

How do you know which contacts are the right way?

Gently squeeze the lens as if you were trying to fold it in half. While squeezing, look at the edge of the lens. If its pointing upwards, or if the edges appear to meet, then the lens is the correct way around. If it bends outwards towards your finger and thumb, then the lens is inside out.

Can I order more contacts without an eye exam?

All contact lenses are FDA-regulated medical devices that require a prescription, even if they dont correct your vision.

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How do I know which contact solution to buy?

How to Choose the Right Contact Solution in 5 Easy Steps Step 1: Determine Your Contact Type. Before choosing a contact solution, youll need to know which kind of lenses you use. Step 2: Learn About Different Solution Types. Step 3: Make a Choice. Step 4: Assess How You Feel. Step 5: Follow the Directions.