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Patient Info
Patient Name
Tint Details
Tint
Solid - $15
Gradient - $20
Bi-color - $25
Tint 1
Grey
Brown
Sand
Rose
Blue
Green
Purple
Black
Amber
Tint %
0
5
10
15
20
25
30
35
40
45
50
55
60
65
70
75
80
85
90
95
100
Tint 2
Grey
Brown
Sand
Rose
Blue
Green
Purple
Black
Amber
Tint %
0
5
10
15
20
25
30
35
40
45
50
55
60
65
70
75
80
85
90
95
100
Lens Details
Color
Edge
Yes
Frame Type
Polish
Yes - $5
Prescription
Right
Left
Right Options
AXIS R
S.H. R
DPD R
Left Options
AXIS L
S.H. L
DPD L
Additional Instructions
Extra Charges Cost
Extra Charges Description
Update Order