In-Office Order Request in Skokie, IL | Shvartsman Eyecare, P.C.

You can also order your contacts online by clicking here!

We are happy to offer competitive pricing on our contacts. We set our prices with 1800 Contacts and include taxes in the price. Annual supplies often include rebates which often result in lower than internet pricing.

Please use this form for general information purposes only. DO NOT send personal health information through this form. Specific patient care must be addressed during your appointment.

Name*

Phone*

Email*

Brand of Contacts: (if known)*

Quantity*

Right Eye	Left Eye

(rebates available on certain quantities, please check current rebates listed below)

Shipping Method:

Ship to Office: - 3-5 business days FREE
Ship to Office: - over night (must call office and place order before 12pm) $17.90
Ship to Patient: - 7-10 business days $6.95 (will ship for free if annual supply or at least 4 boxes of daily disposables)
Ship to Patient: - Over Night (must call office and place order before 12pm) $17.90

Address for Shipping:

Street Address Address Line 2 City State ZIP Code

I have Eyemed Insurance benefits to be applied:

Yes
No

Message From Staff

A staff member from Shvartsman Eyecare will confirm your order within 48 hours or less. Please feel free to call the office at 847-423-2191 if you have any questions or are in urgent need of lenses. As always, we appreciate your business.

Shvartsman Eyecare, PC

Email

This field is for validation purposes and should be left unchanged.

Message From Staff

Shvartsman Eyecare, P.C.

Office Hours