Harvey & Lewis  
 
 
 
 
  re-order contact lenses

Time to reorder contact lenses? Complete the form below and we will process your order as soon as possible.

The online order process is simple.

After we receive your order request we will verify that you have a current prescription on file (within the past year). If your prescription is eligible, you will receive an email containing a link for payment and delivery options. If your prescription is not eligible, you will receive an email with a link to our online eye exam scheduling page prior to receiving new contact lenses.

Fields marked with a * must be filled out for us to process your order.

 
CONTACT INFORMATION*
Name:
   

Address:

City:
State:
Zip:
Email:
Phone:
 
Preferred method of contact:
Email Phone
 
ORDER INFORMATION*
Brand of Contact Lenses:



Number of Boxes:
 
What location did you last purchase contacts from?
Hartford Hospital
Kensington
West Hartford
How did you hear about us? *
 
NOTES

Please use this space to indicate preferred doctor or other special needs/concerns.

 
 
 
  Harvey and Lewis Opticians | 45 Asylum Street Hartford, CT 06103 |Tel 860-522-2020 | Fax 860-522-5277 | info@harveyandlewis.com
Web Development by Crucial Networking