Welcome to the EPIC Labs online order form.

PLEASE NOTE! Pressing the “ENTER” or “RETURN” keys will automatically submit your form, even if not completed yet. Instead, use the “TAB” key to advance from field to field. Please click the “SUBMIT ORDER” button to send your completed order.

Customer Information

Contact/Business Name

E-Mail Address


This field must be filled out correctly
or you will not receive a copy of this order.

Account #

Tray #/Patient Name

Job Status

If you select "Quote First" we will call you to give you a quote before processing. If you select "Start Job" we will process the job immediately.

Please note that jobs with incomplete information or with limiting parameters will result in a phone call for clarification.

   

Rx Information

 

Edged/Uncut

 

 

 

 

 

 

 

 

Sphere Power

Cylinder

Axis

Horizontal
Prism (I/O)

Vertical
Prism (U/D)

 

R

 

L

 

 

Add Power

Seg Style

Seg Height

OC Height

Distance PD

Near PD

R

L

 

 

 

 

 

 

 

Material

Please enter material as well as color.
EXAMPLES:
1.56 Sunsensor Brown,
Plastic, Clear
Poly Polarized Gray

Also specify any desired manufacturer.

 

Scratch Coating

Epic automatically scratch coats the back side on all Poly, Trivex, High Index and Mid-Index 1.55 and higher. If you'd like one of these lenses without back-side coating, please specify "No Back Coat".

CR-39 will be uncoated unless otherwise stated.

 

 

 

 

 

 

 

 

 

Slab-Off ? (Y/N)

If "Yes", slab eye only or full pair?

 

Prism Thin (Y/N)

If "Yes", then what amount?

 

Thickness (Dress/Safety)

For any other information regarding special thicknesses, please note in the "Comments" section below.

 

 

 

 

 

 

 

 

 

Please inform us of all special needs. For more complex jobs please call Epic Labs toll-free at 877-374-2522

Comments/Special Instructions

 

 

 

 

 

 

Frame Information

Style

 

Frame Size

A

 

DBL

 

B (Vertical)

 

ED

 

 

 
Phone/Fax Ordering
p:877-374-2522
f:800-666-4513
email: info@epiclabsinc.com

 

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