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Before you submit, make sure you have your Order information and Payment Information found in the email.
This form below is reserved for employees purchase at a CooperVision Business Partner location.
































If you haven't received an email with your Order number and Payment information, please contact orders@coppervision.com. 






























































































































































































































After submitting your payment, please allow 3-10 business days for handling time. Once your order does ship, you can expect to receive it in 3-5 business days.
































































































If you cannot see the form above, please click on the button below "Access Payment Form".