Submit Your Prescription Order

Please complete the Optical Lab Order Form with all relevant details.

📌 Important: the more information you provide, the faster and more accurately we can complete your order.

⌛️Lead time: 7-10 Business Days

Optical Lab Order Form

Contact Email *

Company Name

Patient Name *

Tray ID

Purchase ID

Frame Style

Frame Type *

Frame Source

Edge (Yes/No) *

A *

B *

ED *

DBL *

Diameter-H

Diameter-V

Tilt

Wrap

SPH *

CYL *

AXIS *

ADD *

DPD *

NPD

SH *

Prism1

IN/OUT

Prism2

UP/DOWN

BASE

DEC_X

DEC_Y

PRISM

ANGLE

Lens Material *

Lens Option *

Lens Type *

Treatment

Tint Type

Color1

Color2

Customize

Emergency (Yes/No)

UV400

Quantity

Remark

Required fields marked with *.

📄 Lens Price List

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Submit Your Prescription Order

Optical Lab Order Form

📄 Lens Price List

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