Give Us a Call
(505) 247-1073

Re-­Order Contact Lenses Online
Fill out this order form so we can evaluate your request. We will call you to confirm your payment method & order requirements. If you have any questions, please give us a call at (505) 247-1073.
* Required
1.
 Are you a new or existing patient? *
 Mark only one.


2.
  Date of Birth *
 (mm/dd/yyyy)


3.
 Which eye(s) are you ordering contacts for? *
 Please select eye(s)
 Mark only one.



4.
 Vision Insurance Info (Optional)
 Enter plan provider and your ID # ­
(Note: Medicaid does not cover contact lenses)


Contact Info
We will contact you to confirm your order and payment.
5.
 Name *


6.
 Phone Number *


7.
  E­-mail *


8.
  Preferred Contact Method *
 Check all that apply.


9.
  Questions & Comments



5700 SAN ANTONIO DRIVE NE I SUITE B4, ALBUQUERQUE, NM 87109
HOURS
MONDAY -THURSDAY: 8:00 - 5:00 PM
FRIDAY: 8:00 - 1:00 PM
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Lovato Eyecare 5700 San Antonio Drive NE Suite B4 Albuquerque, NM 87109 Phone: (505) 247-1073 Fax: (505) 247-2153

Lovato Eyecare proudly serves Albuquerque, NM and the surrounding areas of Rio Rancho, Corrales, Placitas, Cedar Crest, Tijeras, Los Lunas, Belen and Edgewood.

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