Mediflex® Aquafinity Toric 116

Mediflex

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Right eye (OD)

1 box
Left eye (OS)

1 box

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How will you provide your contact lens prescription?

Existing Patient

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Enter Prescription

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this will be saved for future use
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Email us a copy of your prescription after placing your order

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prescription for? *

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Last Name*

Date of Birth*

Send your contact lens prescription later

You can send us your prescription later by email to office@drbrucecoward.com
Upon completing your order, you will receive a reminder.
Alternatively, you can enter your prescription now.

Who is the
prescription for? *

First Name*

Last Name*

Upload your contact lens prescription

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Prescription *

Take a photo of your paper prescription

Upload Prescription Allowed Types (PDF, PNG, JPEG, JPG)

Prescription uploaded Details will be added to your order after checkout.

Who is the
prescription for? *

First Name*

Last Name*

Enter your contact lens prescription

Right Eye (OD)
Sphere Base Curve Diameter Cylinder Axis
Left Eye (OS)
Sphere Base Curve Diameter Cylinder Axis

Who is the
prescription for? *

First Name*

Last Name*

Date of birth*

We need to verify your prescription

Contact lenses are medical devices and require a prescription.

Verification
method *

Upload your prescription A contact lens prescription valid
within the expiry period

Verify with my doctor Provide your doctor contact details and your date of birth.

* Please select a verification method.

Doctor Details *

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Doctor Email * Valid email address is required
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I authorize Dr. Bruce Coward & Associates to contact my doctor and obtain prescription information*

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Back

Quantity discounts available:

Mediflex® Aquafinity Toric 116

Mediflex

$73.00
per box

(6 Lenses)

How will you provide your contact lens prescription?

Existing Patient

Enter Prescription

Upload Prescription

Send Later

Existing patient?

Who is the
prescription for? *

Send your contact lens prescription later

Who is the
prescription for? *

Upload your contact lens prescription

Upload
Prescription *

Prescription uploaded Details will be added to your order after checkout.

Who is the
prescription for? *

Enter your contact lens prescription

Who is the
prescription for? *

We need to verify your prescription

Verification
method *

Doctor Details *

Enter Name/Eyecare Provider

Mediflex® Aquafinity Toric 116

Delivery & Returns

Delivery

Returns and exchanges

Back

Quantity discounts available:

Mediflex® Aquafinity Toric 116

Mediflex

$73.00 per box

(6 Lenses)

How will you provide your contact lens prescription?

Existing Patient

Enter Prescription

Upload Prescription

Send Later

Existing patient?

Who is the prescription for? *

Send your contact lens prescription later

Who is the prescription for? *

Upload your contact lens prescription

Upload Prescription *

Prescription uploaded Details will be added to your order after checkout.

Who is the prescription for? *

Enter your contact lens prescription

Who is the prescription for? *

We need to verify your prescription

Verification method *

Doctor Details *

Enter Name/Eyecare Provider

Mediflex® Aquafinity Toric 116

Delivery & Returns

Delivery

Returns and exchanges

$73.00
per box

Who is the
prescription for? *

Who is the
prescription for? *

Upload
Prescription *

Who is the
prescription for? *

Who is the
prescription for? *

Verification
method *