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Eye Lab Rx • 918 Mansfield Dr. • Fort Collins, CO 80525 • 970-430-2006
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  1. Completely fill out your mail-in order form, including your address and payment information.

  2. Have your eyecare practitioner complete and sign the prescription form.
    Your PD (distance between your pupils) must be included or include a photocopy of
    your current prescription with your PD measurement.

  3. Choose your sunglasses or goggle.

  4. Mail or fax both the completed order form and prescription release form to:

    Eye Lab Rx
    918 Mansfield Dr.
    Fort Collins, CO 80525
    Phone: 970-430-2006
    Fax: 206-337-1379