Form Test

Your age?

How much do your regular prescription glasses and sun glasses cost? If you only have contacts enter $0.

On Average, how many years between new pairs of glasses?

When visiting the eye doctor what is your normal co-pay

How many years between visits to the eye doctor?

On Average, how many boxes of contacts do you use in a year?

How much do you pay per box of contact lenses?

How many bottles of contact cleaning solution do you use per year?

How much does a bottle of your contact cleaning solution cost?