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Upload Photo Prescription

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Last name is required.
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Prescription photo is required.

Upload prescription for selected glasses

Have us call your doctor

Enter in your eye doctor’s information, and we’ll reach out to obtain your prescription information.

Patient's full name is required.
Patient's birthdate is required. format: mm/dd/yyyy
Why do we ask for this
Doctor or clinic name is required.
Doctor or clinic phone is required. format: 000-000-0000
State is required.
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Send it to us later

We will send you a reminder to send us your prescription so we can get your order ready for shipping.

First name is required.
Last name is required.
Email Address is required.
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