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FREE TRIAL CONTACT LENSES
Free Trial Contact Lenses
Fill out this form, and get free trial contact lenses
*[Silicone Hydrogel Contact Lenses are available in select powers in select cities]
Do you use Contact Lenses?
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Yes
No
Brand
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Acuvue Contact Lenses
Bausch + Lomb
Ciba Vision
Freshlook
Others
Type
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Select
Daily
Monthly
Yearly
Usage Period
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First time user
Less than 6 months
6 months to 1 year
1 year to 2 years
More than 2 years
Lens Power Right Eye
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Select
-0.5
-0.75
-1
-1.25
-1.5
-1.75
-2
-2.25
-2.5
-2.75
-3
-3.25
-3.5
-3.75
-4
-4.25
-4.5
-4.75
-5
-5.5
-6
Lens Power Left Eye
*
Select
-0.5
-0.75
-1
-1.25
-1.5
-1.75
-2
-2.25
-2.5
-2.75
-3
-3.25
-3.5
-3.75
-4
-4.25
-4.5
-4.75
-5
-5.5
-6
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Mumbai and Thane
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Visakhapatnam (Vizag)
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