This service is only available if you have a current prescription with Focal Point Optometrists. Please fill in the form below. We will contact you as soon as your contact lenses have arrived.
Are you an existing client
Full Name*
Date of birth* Day12345678910111213141516171819202122232425262728293031 MonthJanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember Year192619271928192919301931193219331934193519361937193819391940194119421943194419451946194719481949195019511952195319541955195619571958195919601961196219631964196519661967196819691970197119721973197419751976197719781979198019811982198319841985198619871988198919901991199219931994199519961997199819992000200120022003200420052006200720082009201020112012201320142015201620172018
Day time phone no.*
Email address*
Number of boxes
Right eye 012345678910 Left eye 012345678910
COMMENTS/REQUESTS
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We will contact you when your contact lenses are ready for pick up. If you have any queries please contact us.