Optometrist Registration

Aniseikonia Solved

Registration form. Download the SHAW™ lens design software and start prescribing for your patients. Please complete the following application form.

Shipping:

PRACTICE NAME *

ADDRESS *

CITY *

PROVINCE/STATE *

COUNTRY *

ZIP/POSTAL CODE *

Please list the prescribing optometrists in your practice.*

Please let us know whom we should contact about the SHAW lens.

CONTACT PERSON*

CONTACT EMAIL*

CONTACT PHONE*

Billing:

Please bill us at our practice address, above

NAME*

ADDRESS*

CITY *

PROVINCE/STATE *

COUNTRY *

ZIP/POSTAL CODE *

CONTACT NAME*

CONTACT EMAIL*

CONTACT PHONE*

You will receive a confirmation email
shortly after registration form submission.

© Shaw Lens Inc. 2024. SHAW™, ANISEIKONIA SOLVED™, Double Bulls Eye Design™, and SHAW LENS & Double Bulls Eye Design™ are trademarks of Shaw Vision Inc. and are used under license by Shaw Lens Inc.