Get Glasses Prescription Order Form - Infab

This guide provides detailed instructions on completing the Glasses Prescription Order Form by Infab online. By following these steps, users can ensure accurate and efficient submission of their glasses prescription.

Follow the steps to complete your prescription order form accurately.

1. Press the ‘Get Form’ button to access the Glasses Prescription Order Form and open it in a suitable editor.
2. Input your company name in the designated field at the top of the form.
3. Enter a contact telephone number where you can be reached.
4. Provide your company purchase order number for reference.
5. Fill in the patient's name to ensure the prescription accurately matches the individual.
6. Indicate the date on which you are filling out the form.
7. Complete the 'Ship to Address' section with the recipient's full address, including city, state, and zip code.
8. Enter the specific glasses model number in the corresponding field.
9. Include the lead equivalency value, which is specified as .75 mm.
10. Select the type of prescription by marking one of the options: Single Vision, Bifocal, or Bifocal Progressive.
11. Provide the prescription details for each eye: Sphere, Cylinder, Add for Bifocal/Progressive, and Axis. Ensure both right (R) and left (L) details are filled out.
12. Input the segment height, which is crucial for ensuring proper lens fit.
13. Measure and include the pupillary distance (PD) in millimeters, ensuring you follow the required format.
14. Remember that PD must be included for Single Vision prescriptions, while both PD and Segment Height must be included for Bifocal/Progressive prescriptions.
15. Obtain the dispensing optician's signature to validate the prescription.
16. Photo copy the finished form and submit it via mail or fax to Infab Corporation at the address or numbers provided.
17. Finally, save all changes made to the form. You may also choose to download, print, or share the completed form as required.

Complete the Glasses Prescription Order Form online now for a smooth and efficient order process.