Loupes

Loupes Repair

1) Submit this repair form
so we can process your repair

2) Remove headlight from loupes
DO NOT SEND HEADLIGHT WITH LOUPES
In the unlikely event your headlight
also needs repair please visit our
Headlight Repair page

3) Ship only your loupes
WITH A COPY OF THE CONFIRMATION EMAIL
 you receive upon submitting this form to:

Designs For Vision, Inc.
4000 Veterans Memorial Hwy.
Bohemia, NY 11716
ATT: REPAIRS

First Name*
Last Name*
Suffix

Profession*

Account #

Best way to contact you regarding repair:*

E-Mail*

Telephone

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Fax

Shipping Address
Street*
City*
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Billing Address
Copy From Shipping Information
Street*

City*
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Loupes Repair
Full Name Engraved on case
Frame
Color
New Prescription

R
L
Details of
Requested
Repair

**Please ship your repair with a copy of the confirmation email you will receive upon submitting this form.**

Please email me special offers, product announcements, warranty and technical information.

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