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Send in your frames for new prescription lenses.

Did your prescription change?  Are your lenses scratched? Send in your existing pair of glasses for new lenses.  Print this form and send it with your frames and a copy of your prescription to: 1553 11th St., West Linn, OR 97068.  We will contact you if we have any questions.

Name:_____________________________________________________________

Address:  __________________________________________________________

__________________________________________________________________

City:_____________________________________________________________

State: ________________________________________

Zip:__________________________________________

Phone: _______________________________________________

Email: ___________________________________________________________________

 

What type of lenses do you want made into the glasses?  (i.e. polycarbonate, transitions, polarized, etc.) See full list of lens options here. Or just write "call me to discuss"

Lens Type (circle)  Single Vision Distance Only       Lined Bifocal       Standard Progressive     Sport Progressive (maximizes distance with narrow reading zones)

Lens material (circle)  Standard CR-39 Plastic (not impact resistant)      Polycarbonate (impact resistant)    Trivex (impact resistant zero distortion)

Upgrades:  (i.e. Tint or Polarized or Photochromic, etc).:______________________________________________________________________

Any Coatings?______________________________________________________________________

Anything else?______________________________________________________________________



How do you want to pay? 

(circle)  Invoice me via Email         Invoice me via Paypal     Use my credit card below


Credit card number:  ___________________________________________________________________________

Expiration date: ______________________________________________________________________________

CVC Security code:  _________________________

 

Include frame and a copy of your prescription and send to:  A Sight for Sport Eyes, 1553 11th, West Linn, OR 97068

Please note:  We are not responsible for frames that break during lens installation. If the frame is old and brittle, it may not be able to withstand the heating process for lens insertion.  Some frames we sold to you in the past may be covered under warranty.