Gateway Vision Dr David Friedman Westford, MA

Now ordering your contact lenses is as easy as the click of a button!
Just fill out the form below. Our office will call to confirm your order and price.

If we did not prescribe your contact lenses, a copy of your unexpired contact lens prescription must be provided either by fax, US mail, or simply email an attached scan of your CL Rx.

Please provide the following information:

First Name

Last Name

Home Phone

Work Phone

ext.

Date of Birth
email address
Preferred method of Contact Best Time to Call
How did you hear about our web site?

Please add the following information if Dr. Friedman is not currently your eye doctor:

Street Address

Address (cont.)

City

State

Zip

Choose one of the following options for providing us a copy of your doctor's contact lens prescription form:

Please note that we cannot process your order until we have received a copy of your un-expired contact lens prescription form.

How many contact lenses/boxes for the Right Eye?
How many contact lenses/boxes for the Left Eye?

Choose an option:
Office Pick up
Ship to the following address:

Street Address

Address (cont.)

City

State

Zip

Contact Phone

ext

Additional Details

David L. Friedman, O.D., P.C.

Gateway Vision Eyecare Center