Paris Optical Laboratory, ONLINE ORDER Page

Online Order

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OFFICE NAME:

YOUR TELEPHONE:

PATIENT'S NAME:

YOUR EMAIL:

DATE:

REFERENCE:

MATERIAL

POLYCARB
PLASTIC (Cr39)
HI INDEX

TRIVEX
GLASS
(OTHER)

TRANSITION
SUNSENSOR
PHOTOCHROMIC
POLARIZED

sphere

cylinder

axis

prism

base

UNCUT
COMPLETE
SAFETY 3.0
STOCK FINISHED
EDGE ONLY

ENCLOSED
FRAME
LENS

add

seg height

oc height

pdd

pdn

   SV
   FT 25
   FT 28
   FT 36
   FT 45

   TF 7 X 25
   TF 7 X 28
   TF 8 X 35
   OTHER
   PROGRESSIVE

   EXEC. BI-FOCAL
   EXEC. TRI-FOCAL
   BLENDED 28
   ROUND

   SCRATCH COATING
   UV COATING
   AR COATING
   TINT COLOR
         SOLID   GRADIENT

EYE SIZE

DBL

LENS MOUNTING

METAL GROOVE (RIMLON)
ZYL DRILL (3-PIECE)

FRAME MANUFACTURED

SPECIAL INSTRUCTIONS:

FRAME MODEL

FRAME COLOR

TEMPLE

Paris Optical Laboratory
9371 Kramer Avenue, Suite F
Westminster, CA 92868
TEL: (800) 449-1440
TEL: (714) 897-9474 FAX: (714) 897-7434
email: info@parisoptical.com

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