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Contact Lens Order Form

If you’re an existing Visual Eyes patient, you can order your contacts right here, right now. Simply fill out the form below to request your contacts. Our office will process your order and follow up with an order confirmation.

Would you like to pick up in office or have the contacts shipped directly to your provided address?
Insurance: If available, would you like us to apply your insurance allowance?
Thanks for ordering your contacts. Our office will process your order and follow up with an order confirmation.

CONVENIENT MIDTOWN LOCATION

Exams & Retail Store

Visual Eyes Optical

1104 S 76th Ave

Omaha, NE 68124

Contact Us

Hours

Mon - Fri: 9am to 5:30pm

Sat: 9am to 1pm

Closed Sundays

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