Contact Lens Order Form

Please Note: In order to complete any contact lens order, patients must have had a contact lens evaluation within the past calendar year with updated lens information on file. Otherwise, please call our office  if you need to schedule an appointment.

If you would like to preview our CL price list, please click on the link below. Prices are set at per lens/box pricing. Some manufacturers offer mail-in rebates, ranging from $30 - $80, for disposable supplies that are ordered in 6 month or yearly quantities. These will automatically be sent with your order.

Contact Lens Price List (click here)

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Order Information:

For non-disposable Contact Lens wearers:
I would like to order: 1 lens Right eye
  2 lenses (both eyes) Left eye
For disposable Contact Lens wearers:  
I would like to order: Box(es) Right eye Box(es) Left eye
*Most brands package 6 lenses/box


Personal Data:

*DOB: (mm/dd/yyyy)
*Note Lenses Cannot be shipped to P.O. boxes.
*City:  *State:  *Zip:   
I would like to pickup lenses: go to Flemington office go to Clinton office go to Bridgewater office

Special Order/Instructions:

  I would like to receive LASIK information

Our Physicians

Locate Our office

Tel: 908-526-4588
Fax: 908-231-6718
1 Monroe St.
Bridgewater, NJ 08807
click here for hours & directions
Tel: 908-824-7144
Fax: 908-968-3239
6B Minneakoning Rd
Flemington, NJ 08822
click here for hours & directions
Tel: 908-735-4100
Fax: 908-735-7494
64 Walmart Plaza
Clinton, NJ 08809
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Contact Our Office

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