Please fill out a few simple questions below. Mayers Eye Solutions will then pull your chart and order your contact lenses for you. Please allow 1 week for contact lenses to arrive in our office. We will contact you using your preferred method of contact when they arrive. Thank you for choosing Mayers Eye Solutions!
Contact Information
First Name
Last Name
Email Address
Home Phone
Work Phone
Cell Phone
Preferred way to contact you when contact lenses arrive:	Home Phone Work Phone Cell Phone Email Me
Lens Information
How many boxes would you like for your RIGHT eye?
How many boxes would you like for your LEFT eye?
Additional Comments/Questions
As always, feel free to contact us at 614-438-0100 if you have any comments, questions, or concerns.