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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
8:30 - 5:00
Tue
8:30 - 5:00
Wed
8:30 - 12:00
Thu
8:30 - 6:30
Fri
8:30 - 5:00
Sat
Call For Hours
Sun
Closed
619 East Lawn Road
Nazareth, PA 18064
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(610) 759-1635
Nazareth Eye Associates 619 E. Lawn Rd. Nazareth, PA 18064 Phone: (610) 759-1635 Fax: (610) 759-1899

Nazareth Eye Associates proudly serves Nazareth, PA and the surrounding areas of Stockertown, Tatamy, Belfast, Bath, Chapman, Philipsburg, Easton, Bethlehem, Allentown, Bangor and Wind Gap.

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