Order your contact lenses from Colleyville Vision Associates

Contact Lens Refills
If you are a current patient, we will have your contact lens prescription in our office and you may order additional contact lenses using this form. We will call you when they have arrived, and you can either come by to pick them up or we can mail them to you. All contact lens wearers should see their eye doctor on an annual basis to maintain good eye health.

Orders will be available for pick up at our office in most cases within 5 working days. Direct shipping is also available at an additional charge. If you desire this option, indicate so on the form below.

First Name
Last Name
Street Address
City
State
Zip Code
Email Address
Phone	- -

Right Eye Lenses
Left Eye Lenses
Check here if you would like to have your order shipped directly to you. *
Questions, Comments or Requests:

* $5.95 shipping will be added to your order.
Some manufacturers waive the shipping charge for a full year supply.
We will let you know if this is applicable when we contact you to confirm your order and payment method.

If you have difficulties with this form, you may send an email to us at
Office@ColleyvilleVision.com or contact us by phone at
(817)498-2010 Metro, or (817)428-0457.

Remember: Regular eye care assures optimal vision correction.




On Hall Johnson Road just west of Colleyville Boulevard (Highway 26)