Order Contact Lenses

    This form can only be used by current patients of Manchester Eye Care to order contact lenses. If you want to use insurance benefits to order your contact lenses, please call us at (636) 227-8700.

    Your First Name (required)

    Your Last Name (required)

    Your Email (required)

    Your Phone Number (required)

    How many boxes of contact lenses would you like to order for your right eye? (required)

    01234

    How many boxes of contact lenses would you like to order for your left eye? (required)

    01234

    Would you like to pick your contacts up at our office? Or, would you like them shipped to you? (required)
    Pick them up.Have them shipped.

    If you are picking your contact lenses up at our office, you may pay for them when you pick them up.

    If you are having your contact lenses shipped to you, we will email you a PayPal invoice for payment and for your shipping address once we have verified your prescription. PayPal accepts Visa, MasterCard, Discover, and American Express. You will receive FREE shipping on web orders.

    Thank you for ordering your contact lenses online at manchestereyecare.com!