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Place an Order for Contact Lenses:
Account Number:*
 Account Name:
Your Name:*
 Your E-mail:
Patient's Name:*
 Your Phone Number:
Lens Brand/Type:
 Boxes/Vials:
 Trials:
OD  -  Qty:
 BC:
 Power:
 Diam:
 Add:
 Color:
OS  -  Qty:
 BC:
 Power:
 Diam:
 Add:
 Color:
OD    K Readings:
 OD  Rx:
 OD Rx Add:
OS    K Readings:
 OS  Rx:
 OS Rx Add:
Additional Information For GP Contact Lenses:
GP Lens
Design:
 GP Lens   
Material:
 OD Tint:
OS Tint:
Warranty:
 Exchange:
 Dot OD:
 No Dot:
 Dot OS:
 GP Lens Adds:
Non-Warr:
 Duplicate:
 Previous Order #:
 Add Seg / Zone:
PlasmaEYEZ GP
Lens Treatment:
 OD Lens CT:
 OD Lenticular:
 OD Lent Bowl:
OS Lens CT:
 OS Lenticular:
 OS Lent Bowl:
Request Consult Call:
Additional Parameters
and/or Instructions:
Orders will be shipped by
your default method unless
specified otherwise.
After submitting an order, use your web browser's <BACK button at the top left of the order confirmation
webpage to return to this Ideal Optics website to place more orders.
Ideal Optics - Contact Lens Orders
We Fit Your Practice™
We can only process orders for eye care practitioners that have active accounts with Ideal Optics.  
For information on setting up an account please call 800.554.7353.            * Required Fields
Ideal Optics
2255 Cumberland Pkwy, Bldg 500
Atlanta, GA  30339-4524
PH: 800.554.7353       
FX:  770.434.8291