Name: OSP (Monthly) - Ultra™
SKU: 1158
Price: 25.00 USD
Availability: InStock

Step 1: Your Prescription

We need an updated prescription in order to send your lenses! If you don't have an updated prescription, visit your local optometrist to get an eye exam.
First Name*
Last Name*
Email Address*
DOB*
Date Format: MM slash DD slash YYYY
Prescription*
- Upload a Picture
- Manually Enter
Take a photo of your paper prescription and your contacts will ship faster!*
Right Eye
Right Eye Power (OS)*
Right Eye (Dia)*
Right Eye (BC)*
Right Eye
- Check this box if you have astigmatism or presbyopia
Right Eye (Cyl)
Right Eye Axis
Right Eye Add
Left Eye
Left Eye Power (OD)*
Left Eye (Dia)*
Left Eye (BC)*
Left Eye
- Check this box if you have astigmatism or presbyopia
Left Eye (Cyl)
Left Eye Axis
Left Eye Add
Your Clinic Info
Full Name of Eye Care Clinic*
Eye Clinic Phone Number*
Street Address of Eye Clinic*
Street Address City State ZIP Code

Step 1: Your Prescription

Step 2: Your Solutions