Harvey & Lewis  
 
 
 
 
 

personal shopping

We are pleased to introduce our new, complimentary personal shopping service. Whether you want to update your current style, achieve a whole new look, or need occasion-specific eyewear, our experienced, professional staff will be happy to assist you.

To better prepare us to meet with you, please fill out the questionaire below. All fields in bold are required.

Your Name:
Your Email Address:
Phone Number:
Appointment Preference:


Appointment Location:
I currently wear the following:



What brand of eyeglasses do you currently wear?
My fashion sense is best described as:
Do you participate in any of the following (please check all that apply):


My eye color is:
I use a computer:
Would you like to upload a picture of yourself to assist us in pre-selecting frames for you?
Would you like to schedule an eye exam with your personal shopping appointment?

Who is your insurance provider?

 


 

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