If
you are an eyecare practitioner and would
like to be referred
patients interested in
COLOR FREE AR — The Invisible
Lens™,
please fill out the form below to register.
Your
First Name
Your
Last Name
Store
Contact's Name
Store
Name (Retail Location)
Address
CityState
Zip
E-mail
Address
Preferred
Lab
Lab's
Address
CityStateZip
Do
you currently sell Optima lenses? Yes
No
Which products?
RESOLUTION®
COLOR FREE AR — The Invisible Lens™
Polartec® 1.67
Do you do
your own edging?
or surfacing?
Would you
like a representative to call you? Yes
No
How
did you learn about our web site?
Trade Ad
Web Search Engine
Customer
Lab Rep
Other
You
will be notified by e-mail once your location has
been added to our database.
