RX Info

Complete the form below then we will follow up with you so we can best suit your needs.

Name *

First

Last

Email *

Address

Address Line 1

Address Line 2

City

State

Zip Code

Phone Number *

OD (Right eye) Sphere (SPH)

OD (Right eye) Cylinder (CYL)

OD (Right eye) Axis (AX)

OS (Left eye) Sphere (SPH)

OS (Left eye) Cylinder (CYL)

OD PD (Pupillary distance) Right eye

OS PD (Pupillary distance) Left eye

Select a Frame Style

Select a Polarized Lens

Hook Optics.