Let's get your prescription!*

Let's get your prescription!*

We need one last (very important!) thing before we can get started on your order: an up-to-date prescription uploaded to our HIPAA Compliant Form. We will expedite your order within 48 business hours after receiving your details.
Name

First NameLast Name
Email*
example@example.com
Order ID*
Choose a Method

Upload RX PrescriptionHave us contact your doctor
Country
Phone Number
FormNo
Upload Prescriptions

Browse Files
Please upload a valid RX Prescription. (Only *.pdf, *.png, *.jpeg or *jpg files) Cancelof
Provide Optometrist Details
Optometrist Name

First NameLast Name
Optometrist Email
example@example.com
Optometrist Phone Number

Area CodePhone Number
* This information is mandatory

For more information or other queries, reach out to us at support@swati.com
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