(814) 796-1133
Map Us

Click for menu

Order Contacts Patient Info Health History

Order Contacts

Fill out this order form so we can evaluate your request. We will call you to confirm your payment method & order requirements. If you have any questions, please give us a call.

Full Name

Date of Birth (mm/dd/yyyy)

Phone (xxx-xxx-xxxx)

Patient Status

Which eye(s) are you ordering contacts for

Vision Insurance Info (Optional)
Enter plan provider and your ID #
(Note: Medicaid does not cover contact lenses)

Notes

Captcha:

Enter Letters/Number you see:

503 High St.
Waterford, PA 16441
(814) 796-1133

Request Appointment

Reviews★★★★★

Keiser Family Eye Care 503 High St. Waterford, PA 16441 Phone: (814) 796-1133 Fax: (814) 796-1133

Keiser Family Eye Care, P.C. proudly serves Waterford, PA and the areas of Erie, Lowville, Fairview, Union City, Edinboro and Cambridge Springs.

Internal Email