Order Contact Lenses Online Name* First Last Email* PhoneWhere you can be reached in the next 24 hoursCell Phone*What types of contact lenses would you like to order? Soft Disposable Soft Non-Disposable Rigid Gas Permeable What type of soft disposable lenses do you wear? Dailies Two Weeks Monthly Quarterly Number of Boxes Per Eye 1 box per eye = 2 boxes total 2 boxes per eye = 4 boxes total Specify a Brand How many boxes per eye? Number of boxes if other than 1 or 2 boxes per eye You will have to pick up your order from our practice.