Basic Online Ordering Form 
​Rx Billiard Rimless Glasses

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Our eyewear is customized to be unique to the wearers facial needs, as well as their respective visual correction, we require a few pictures of the individual and a picture of the Rx. We fabricate all lenses on site at our office. Please read the information below before shopping for Rx Frames.
Important!!!
Note: All fields with an * are a mandatory field. Forms won't go through otherwise. 
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Make sure to hit the submit button when you're finished. If mandatory fields are left unanswered, they will be circled in red.

Step #1: Promotion
    (RayBan Promo: We will discuss colors and sizes after we receive your online order and call you to discuss your selection)
    RayBan Frame: 2132 (New Wayfarer)
    Color: 6052 (Black/Transparent)
    Sizes: 52, 55, 58
    RayBan Frame: 2132 (New Wayfarer)
    Color: 622 (Rubber Black)
    Sizes: 52, 55, 58
    RayBan Frame: 2132 (New Wayfarer)
    Color: 710 (Light Havana)
    Sizes: 52, 55, 58
    Step #2: Patient Information
    Step #3: Shipping & Billing Information
    (If "No'", Please enter billing information below)

    Step #4: Waiver

    Click HERE to Read Our Rx Adaption Policy.
    Step #5: Upload Rx & Photos of Yourself
    Please email or upload a copy of the original Rx. ​We will not process the order until we receive a copy of your prescription.
    ​    (Our Email Address: billcurran2020@gmail.com)
    Max file size: 20MB
    Max file size: 20MB
    Max file size: 20MB
    Max file size: 20MB

    Step #6:​ Select a Frame Design

    - Each Frame Collection Can Be Viewed Below Under Their Available Colors -
    Step #7: Selecting a Frame Color 
    - For Frame Color Purposes Only -
    ​If you clicked on the 'not sure' option, then we will recommend a frame color once we receive your photos.

    ​Note: Certain colors work best with certain hair colors and facial complexions. 
    - Frame Colors Below are for Original Series Only - 
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    Solid Black
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    Brown
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    Satin Gold
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    Blue
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    Silver and Black
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    Grey
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    Purple
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    Wine
    - Frame Colors Below are for Pro-am (Hingeless) Series Only -
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    Blue (4640)
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    Pinecone (6040)
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    Shiny Gold (7530)
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    Slate (4540)
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    Fossil (6560)
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    Rose (3540)
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    Silver (7010)
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    Wine (3040)
    - Frame/Colors Below are for Professional Series Only -
    - For Frame/Color Purposes Only -
    ​If you clicked on the 'not sure' option, then we will recommend a frame/color once we receive your photos.
    Note: Certain frame/color work best with certain hair colors and facial complexions. 
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    Racing (Blue/Orange)
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    Racing: (Color: White/Black)
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    Racing: (Color: Black/Gold)
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    Momentum: (Color: Iceland Black)
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    Momentum: (Color: Silver Pacific Blue)
    Step #8: Select a Lens Shapes (7 Available) 
    All of our work is customized. Once we receive the four (5 optional) close up photos, we will email or call you and discuss lens shapes that we recommend. If desired, we can email a superimposed image of the lens shape over the photo you sent us for a general idea on how they will look.
    These lenses are not one-size-fits-all.
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    Lens Shape: 'Backspin'
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    Lens Shape: 'Sport'
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    Lens Shape: 'Angles'
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    Lens Shape: 'Classic'
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    Lens Shape: 'Cue Ball'
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    Lens Shape: 'Cosmo'
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    Lens Shape: 'Diamond'
    Step #9: Select Your Lens Type
    Step #10: Transitions 8 (changeable lenses) 
    ​- lenses darken when exposed to UV light - 
    Submit Form By Clicking Button Below
    Note: All fields with an **** are a mandatory field. Forms won't go through otherwise. 
    Make sure to hit the submit button when you're finished. If mandatory fields are left unanswered, they will be circled in red.