Reglazing Quote

Reglazing Quote Form

Your details

Title:

First name:

Surname:

Email address:

Phone number:

Type of lens required:

Please tick all that apply. If you're unsure which extras you need, take a look at our reglazing guide

Your prescription

You can add the details below or click the button to upload a copy or photo of your prescription.

If any of these details ie, sphere, cylinder, add do not apply to your prescription please enter 0.00 in the form field.

Right Eye - Sphere/Power:

Left Eye - Sphere/Power:

Right Eye - Cylinder:

Left Eye - Cylinder:

Right Eye - Axis:

Left Eye - Axis:

Right Eye - Add:

Left Eye - Add:

Any Additional Details:

Upload prescription image (up to 10MB):

Your existing frame

You can add the details below - for example plastic, metal, half rim (supra) rimless, or click the button to upload a copy or photo of your current glasses

Details:

Upload photo of glasses:

Extras

Please tick all that apply. If you're unsure which extras you need, take a look at our reglazing guide

Choose Extras:

High index

Hard coating

Anti glare coating

Blue light coating

Transitions or photochromic

Tint