Purchased contacts through us within the last 12 months?  Recently sent home with trials of new contacts?  Please fill out the form below and our doctors will review the feedback and take the necessary action.  Our clinic will contact you with the next steps.

Name *
Name
Phone
Phone
Current contact lens feedback
Current contact lens feedback
Based on the tasks you would like to wear the contacts for (work, sports, social events), please rate the current lenses (if try multiple pairs, please use the additional informaiton box at the bottom to add more details)
Is comfort is acceptable?
Is distance vision is acceptable?
Is reading vision is acceptable?
Next Step?