Prescription Plus PD
Please fill in the form below, with as much detail as you can. Some prescriptions are complex, and some are simple. I will email you with an approximate quote to suit your prescription. If you are unsure, just email me everything written on your prescription provided by your optometrist. Once entered, hit 'Submit' and await my response. Thank you

* indicates required fields 
  Right Sphere:
  Right Cyl Power:
  Right Axis enter number:
  Left Sphere:
  Left Cyl Power:
  Left Axis enter number:
  PD Distance:
  *your email:
  your phone:
  *Country / State:
  Prism RE:
  Prism LE:

After filling in the details click on the 'SUBMIT' button. The page will refresh itself and appear empty, however your email has been sent. If you do not here from us please see our 'Contact Us' page and phone our office.
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