Upload Prescription

Complete the form below and upload your prescription to begin your prescription glasses purchase. Please make sure prescription is uploaded clearly, is of date & legible. If your prescription is accepted, you will be emailed a link to complete your purchase.

PRICE: $499

IMPORTANT NOTES:

Bi-focal & progressive lenses are not available. Prescriptions should be provided as a copy from your doctor. Only prescriptions with your doctor's information and signature are accepted.

To finalize the order, we will need for pupillary distance (PD), before the order can be placed. We prefer the individual PD for each eye to be the most accurate alignment possible.

First Name *

Last Name

Email *

Phone

Lens Type *

Clear
Tint
Photo Fusion
Polarized

Prescription Type *

Standard Single Vision
Freeform Single Vision

Prescription *

Bi-focal & progressive lenses are not available. Prescriptions should be provided as a copy from your doctor. Only prescriptions with your doctor's information and signature are accepted.

Please read FAQ page here to continue

Checkbox *

I have read and agree with the Prescription Lens FAQ

Upload Prescription

Please read FAQ page here to continue

Thanks for submitting your prescription.

Our team will review this submission, and if approved, you will receive an email with steps on how to place your order.

Thanks for submitting your prescription.

Our team will review this submission, and if approved, you will receive an email with steps on how to place your order.

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Coosa XL

4 products

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Coosa XL Gun Metal / Hidden Graphite

Coosa XL Gun Metal / Palm Green

Coosa XL Gun Metal / Night Blue

Coosa XL Gold / Hidden Graphite