Basic Online Ordering Form 
​Rx Billiard Rimless Glasses

(Take Advantage By Using Your Flex Spending or Health Savings Card)
Picture
Click to View Protection Plan
FREE Two Year Protection Plan ($50.00 Value)
​100% Customer Satisfaction Guarantee!
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. 
​
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: Select Your Promotion
    ​When we contact you, please let us know what T-shirt size you prefer. Available Sizes: Small, Medium, Large, XL, 2XL.
    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.
    Email: 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 - 
    Picture
    Solid Black
    Picture
    Brown
    Picture
    Satin Gold
    Picture
    Blue
    Picture
    Silver and Black
    Picture
    Grey
    Picture
    Purple
    Picture
    Wine
    - Frame Colors Below are for Pro-am (Hingeless) Series Only -
    Picture
    Blue (4640)
    Picture
    Pinecone (6040)
    Picture
    Shiny Gold (7530)
    Picture
    Slate (4540)
    Picture
    Fossil (6560)
    Picture
    Rose (3540)
    Picture
    Silver (7010)
    Picture
    Wine (3040)
    Picture
    - Breast Cancer Awareness Month (Pink) -
    - 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. 
    Picture
    Racing (Blue/Orange)
    Picture
    Racing: (Color: White/Black)
    Picture
    Racing: (Color: Black/Gold)
    Picture
    Momentum: (Color: Iceland Black)
    Picture
    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.
    Picture
    Lens Shape: 'Backspin'
    Picture
    Lens Shape: 'Sport'
    Picture
    Lens Shape: 'Angles'
    Picture
    Lens Shape: 'Classic'
    Picture
    Lens Shape: 'Cue Ball'
    Picture
    Lens Shape: 'Cosmo'
    Picture
    Lens Shape: 'Diamond'
    Step #9: Select a Case (Two Case Styles Available)
    Picture
    'Standard' (Hard Case | Color Black)
    Picture
    'Deluxe' (Soft Case w/ Belt Loop | Color: Brown)
    Picture
    'Deluxe' (Soft Case w/ Belt Loop | Color: Black)
    Step #10: Select Your Lens Type
    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.