ON LINE ORDERING NOW
AVAILABLE FOR PRODUCTS
OFFERED TO GENERAL
PUBLIC ONLY
Click on form to enlarge and print off and fax.
1-952-403-7900 -fax
MOST ORDERS RECEIVED BY 2:00 PM
CST ARE SHIPPED THE SAME DAY.
EXPRESS MAIL ORDERS MUST BE
RECEIVED PRIOR TO 2:00 PM CST TO BE
MAILED SAME DAY
ORDER FORMS FOR EYE CARE PROFESSIONALS ONLY
Eye Professionals
Fax Order Form
2 Pages
MYI Occlusion Eye
Patch Order Form
PROFESSIONALS
ORDER FORMS FOR ITEMS AVAILABLE FOR
PURCHASE BY NON-EYE CARE PROFESSIONALS
The Only Products Available to the General
Public are:
MYI Occlusion Eye Patches
Perfect Patch
Apple Patty Patches book
Peepers Eye Glass Holder
Pedi-Wrap Arm Immobilizers
3M Press-On Optics - Aspheric Lenses
and D-Segs
General Public
ProductsOrder Form
MYI Occlusion Eye
Patch Order Form
GENERAL PUBLIC
Note:  Please provide complete
phone number so we may contact
you to confirm shipping information
and collect credit card information.
Thank You
Our office hours are 7:30 am to 4:00 pm cst M-F

  • 1-800-544-4760
  • 1-952-496-0432
  • 1-952-403-7900 -fax

Fresnel Prism & Lens Co.
6824 Washington Ave.S
Eden Prairie, MN  55344
email:  fresnelpnl@aol.com
ORDER FORM
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