Chemistrie Custom Clips (Eye Care Professionals Only)

Ordering Instructions:
1. Fill out the below order form completely and add to cart.
2. At checkout, print completed order form and ship uncut lenses and frame to:
      Zlab/Optisource | 1501 Reedsdale Street Suite 203 | Pittsburgh, PA 15233
 

Customize Chemistrie SunLenses

Lens Selection
Lens Color
Lens Color
Lens Color
Bridge Color
Magnet Color
Magnet Shape
Accessories
Crystal Colors

Additional Information / Special Instructions

Primary Rx Lenses (please check one box below)

Retrofit (not available for three-piece frame): Mount magnets in existing Rx. No new Rx lens provided. Add $10
Uncut lenses included

Sphere Cyl Axis PD ADD Seg HT
OD
OS

Prism ($10 / diopter)
Diopter Base Diopter Base
OD
OS

Reader Rx Lenses

Sphere Cyl Axis PD ADD Seg HT
OD
OS

Power:

Prism ($10 / diopter)

Diopter Base Diopter Base
OD
OS

Chemistrie Lens Total: $65