Trial Request This post was most recently updated on July 8th, 2019 Contact Lens Trial Request If you are human, leave this field blank. We will, at our discretion, provide a set of trial contact lenses in emergency situations to customers who are not patients at our office. In order to do so you must fill out the following form and email or fax us a copy of your valid contact lens prescription. If you do not have a valid contact lens prescription then we are not able to provide you with trial lenses. Fax Rx to (303)844-3940 or email to info@optiqueofdenver.com Once we have received your request form and prescription we will contact you if we have your contact trials in stock. * Pick Up At Store Are You Currently A Patient At Optique Of Denver? * Yes No Lens * 1-Day Acuvue Moist Acuvue Oasys Acuvue Oasys 1 Day Acuvue Vita Air Optix Air Optix Night & Day Avaria Biofinity BioTrue OneDay Clariti 1 Day Dailies Aqua Comfort Plus Dailies Total 1 My Day Proclear Proclear 1 Day PureVision Ultra Options Astigmatism (Toric) Multifocal Colors Quantity Trial Lens First Name * Last Name * Date Of Birth * Email * Phone * reCAPTCHA Submit
