Contact Lens Prescriptions

Phone: <a class="ecp-phone-call-phone" href="tel:248-624-1707 " style="text-decoration:none"> 248-624-1707
Fax: 248-624-0203

Name: Walled Lake
Address: 519 N. Pontiac Trail, Walled Lake, MI, 48390, US
Telephone: 248-624-1707
Price range: $000 - $300

I acknowledge and agree that if I am fit with contact lenses, once the prescription is finalized, I will be provided with a signed copy of my prescription. I consent to receiving either a physical hard copy or electronic email copy of my prescription.
Patient Name*
First Last
Patient Signature*
Date*
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