Rosentreter Ted J - Olathe, KS- Luthi & Rosentreter

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Contact Lenses/Eyeglasses

Appointment/Reorder Contact Lenses

Eye Conditions

Drs Luthi & Rosentreter

Appointment Form

Please complete the following form and click Submit. We will contact you as soon as possible regarding your request.

First Name

Last Name

Street Address

City

State

Zip Code

Daytime Phone

E-mail Address

Preferred Date and Time

Preferred Doctor:

Secondary Preferred Date and Time

How do you wish to be contacted?

Is this your first appointment?

Yes

Health Insurance Company

How did you hear about our service?

Questions or Comments

Contact Lens Reorder

Bold = Required field

If your contact lens Rx is current, simply indicate in the text below the number of boxes you desire ordered, and we will contact you to confirm your order.