Optikal Prescription Form


A current prescription (you have to have been fitted for the contact lens brand that you want to buy) is required in order to purchase your Optikal box. If you don't have an updated prescription, visit your local optometrist to get an eye exam.


If you uploaded a picture of your prescription, scroll down and hit submit. You're good to go! If not, please fill out your prescription manually below (entering manually may delay the process by 48 hours).

Only fill out the below field, if you wear toric lenses/have an astigmatism.
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