Order Contacts at the Fresno office of Eye-Q Vision Care

Please understand that you are submitting this request over the Internet.

Do not include any sensitive medical information in your order request, for we cannot guarantee that it will not be seen by other parties.

Please call our office if there has been a change in your billing information.

* Denotes Required Field

Full Name*
Address
City
State
Phone Number
E-Mail Address *
Eye-Q Account #
Type of contacts
Side
Quantity
Shipping Method	Regular
Shipping Method	Rush
Questions and comments:
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