Contact Lens Order

With New Look Eyewear, you can now reorder your contact lenses on line.

Contact Lens Reorder

Please fill out the following form and one of our employees at the store you selected will contact you to complete your order:

All fields marked with an asterisk (*) are required.

Title *

First Name * Last Name * Telephone (day) * Telephone (evening) Email *

At which New Look store did you buy your last contact lenses?

Store *

Other Information - The following information is not mandatory. However, it may be required to pick up your order.

Birth Date dd/mm/yyyy

Address City Province

Postal Code ex. : A1A 1A1 Notes

Code sécurité

Security Code *