BARRIERS GLASSES Prescription Order Form 2025

Get Form
BARRIERS GLASSES Prescription Order Form Preview on Page 1

Here's how it works

01. Edit your form online
Type text, add images, blackout confidential details, add comments, highlights and more.
02. Sign it in a few clicks
Draw your signature, type it, upload its image, or use your mobile device as a signature pad.
03. Share your form with others
Send it via email, link, or fax. You can also download it, export it or print it out.

How to use or fill out BARRIERS GLASSES Prescription Order Form with our platform

Form edit decoration
9.5
Ease of Setup
DocHub User Ratings on G2
9.0
Ease of Use
DocHub User Ratings on G2
  1. Click ‘Get Form’ to open the BARRIERS GLASSES Prescription Order Form in the editor.
  2. Begin by entering your company name and phone number at the top of the form. This information is essential for processing your order.
  3. Fill in the Purchase Order #, Patient Name, and Date fields to ensure accurate tracking of your prescription order.
  4. Provide the Ship to Address, including City, State, and Zip code. This ensures that your glasses are delivered to the correct location.
  5. Select the Glasses Model # and specify the Type of Script required (Single Vision, Bifocal, etc.). Make sure to fill in all relevant fields for each eye (R for Right and L for Left).
  6. Input measurements for Pupillary Distance (PD) and Segment Height (SH) as indicated. Remember that PD is crucial for Single Vision orders, while both PD and SH are necessary for Bifocal/Progressive orders.
  7. Finally, ensure that a Dispensing Optician's signature is included before submitting. You can then mail or fax the completed form to Infab using the provided contact details.

Start filling out your BARRIERS GLASSES Prescription Order Form online for free today!

be ready to get more

Complete this form in 5 minutes or less

Get form

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.
Contact us
Is It Ok to Get Prescription Glasses Online? Yes! With an accurate prescription and pupillary distance, a pair of prescription glasses ordered online are the same as glasses youd buy in a store.
Simply upload your prescription and your pupillary distance in the suggested file format. With this option, if your prescription is still valid and the order name, address and DOB details match our records we will find it for you.
Following an eye test your ophthalmic practitioner optometrist is legally required to give you your optical prescription or a statement to say youve been referred for further tests.
If a person does not have a copy of their eyesight prescription, they can first contact their eye doctor for this information, as they must provide a copy free of charge. People who need a comprehensive exam or have an eye injury or infection should make an appointment with their optometrist or ophthalmologist.
If considered necessary or appropriate before an order is accepted, we have absolute discretion: (a) to contact directly, or request that you contact, the optician who provided your prescription to verify and/or discuss your prescription; (b) to request that you obtain your pupillary distance measurement from your

People also ask

You typically only need the following to shop for glasses online: Your eye prescription. Your pupillary distance. Your insurance information (if you have vision insurance) Your payment method.

Related links