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Order Contacts
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.
Full Name
Date of Birth (mm/dd/yyyy)
Phone (xxx-xxx-xxxx)
Email
Patient Status
Which eye(s) are you ordering contacts for

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



OFFICE HOURS    
Mon
8:00 - 5:00
Tue
8:00 - 6:00
Wed
8:00 - 6:00
Thu
8:00 - 6:00
Fri
8:00 - 5:00
Sat
Closed
Sun
Closed
4207 Glass Road, NE
Cedar Rapids, Iowa 52402
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(319) 366-4455
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Cedar Rapids Eye Care 4207 Glass Rd. NE Cedar Rapids, IA 52402 Phone: (319) 366-4455 Fax: (319) 362-8461

Cedar Rapids Eye Center proudly serves Cedar Rapids, IA and the surrounding areas of Kenwood Park, Noelridge Park, Mound View, Marion, Hiawatha, Cedar Hills and Toddville.

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