Special Instructions: (Quantity, shipping, note, etc).

PLEASE SELECT PRODUCT 

1) Replacement contact lens (for our existing patients)
   Please send me a RIGHT contact lens (as noted in my file)
    Please send me a LEFT contact lens (as noted in my file)
    Please send me BOTH RIGHT & LEFT contact lenses (as noted in my file)

2) CIBA Dailies (Doctor's authorization required)
     90 wears  
 
3) CIBA Night and Day (Doctor's authorization required)
           6 month supply 

4) CIBA Focus Bifocal Soft Lenses (Doctor.'s authorization required)
           1 box of  6

5) Allergan's Ultra Care
           3 month supply

6) CIBA Solo Care
           2 x 360ml bottles and a new lens care

7) Allergan Complete
           2 x 360ml bottles plus a 60ml traveler bottle & a new lens case      

All deliveries made by commercial courier at rack rates unless otherwise arranged with our office.