Verify your Order

Account Name	Account Number	Dispenser's Name
$customer:acct_name$	$customer:acct_no$	$customer:name$
Patient Name		Patient Address
$form:patient_name$	Mail Patient? $form:patient_mail$	$form:patient_address$

Sphere	Cylinder	Axis	Prism	Prism Direction	Base Curve	Dec.
$form:sphere_right$	$form:cylinder_right$	$form:axis_right$	$form:prism_right$	$form:prism_direction_right$	$form:base_curve_right$	$form:decentration_right$
$form:sphere_left$	$form:cylinder_left$	$form:axis_left$	$form:prism_left$	$form:prism_direction_left$	$form:base_curve_left$	$form:decentration_left$
Add	Height	Opt. Cntr. Location	Inset	Total Inset & Decentration
$form:add_power_right$	$form:height_right$	$form:optical_center_location_right$	$form:inset_right$	$form:total_inset_right$
$form:add_power_left$	$form:height_left$	$form:optical_center_location_left$	$form:inset_left$	$form:total_inset_left$

PD	Mono Dist.	Mono Near
Distance $form:pd_dist$	R: $form:mono_dist_right$	R: $form:mono_near_right$
Near $form:pd_near$	L: $form:mono_dist_left$	L: $form:mono_near_left$
Material	Polorized
$form:lens_Material$ Other: $form:LensMaterialOther$	$form:polarized$

Lens Thickness

$form:lens_thickness$

Please Specify:
O.D. $form:lens_thickness_other_OD$
O.S. $form:lens_thickness_other_OS$

Tints		Tint Type
Plastic Tint? $form:plastic_tints$ (Color: $form:tints_plastic_color$)		$form:tint_type$
Glass Color? $form:glass_tints$ (Color : $form:tints_glass_color$)		Other: $form:tint_type_other$ Tint % $form:tint_percent$
Photochromatic Plastic Type		Special Tinting Instructions:
$form:photochromatic_plastic_type$		$form:special_tinting_instructions$

Lens Measurement	Frame Information	Frame Material	Job Type
A: $form:lens_measurement_a$	Name/Style: $form:FrameNameStyle$	$form:frame_material$	$form:frame$
B: $form:lens_measurement_b$	Manufacturer: $form:FrameMfr$
ED: $form:lens_measurement_ed$	Eye Size: $form:FrameSizeEye$
DBL: $form:lens_measurement_dbl$	Bridge Size: $form:FrameSizeBridge$
C Size: $form:lens_measurement_csize$	Temple Size: $form:FrameSizeTemple$
	Style/Mfr: $form:FrameStyleMfr$
	Color: $form:FrameColor$

Edge	Glass Tempering	Coatings
$form:edge$	$form:glass_tempering$	Scratch Resistant? $form:coatings_scratch_resistance$
		Anti Reflective? $form:coatings_anti_reflective$
		UV Treatment? $form:coatings_uv_treat$
		Mirror? $form:coatings_mirror$
Engrave Temple? $form:edge_engrave_temple$		Color? $form:coatings_other$ $form:coatings_other_text$
Engrave Lens? $form:edge_engrave_lens$		Duralux? $form:coatings_duralux$
Engraving: $form:engraving$	Frame and Lens Packages Fisher Price? $form:Fisher_Price$ STC? $form:STC$ Economy Eyewear? $form:EE$

Special Instructions

$form:instructions$

To make an editing change, use your Browser's "Back" button.
-or-
Forget everything and return to order types page.

Verify your Order

SOLAOne is available in Plastic, Polycarbonate, Transition Plastic, Transition Polycarbonate, High Index 1.60, High Index 1.67

New Kodak InstaShades Lenses Now Available from ROL

PolarShades Now Available in Kodak Precise