LTERB

Let the Eyewear Rumpus Begin!

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Today's Date
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MM-dd-yyyy
Hi! You're in the right place to schedule your glasses consultation. When you finish answering these questions and submitting, the calendar will appear, where you can book your best time.

Please tell me a little about yourself, eyeglasses-wise. Your answers will ensure an efficient consultation and help you get the spectacles of your dreams. These questions should take you no more than 15 minutes to complete. No stress please; just skip any you can't answer, and we'll cover them together when we meet. Thank you!

Your Basics
Name
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Required First Name Middle Required Last Name
Phone *
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### ### ####
Email *
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Date of birth (mm-dd-yyyy) *
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MM-dd-yyyy
Address
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Street Address City State/Region/Province
Postal / Zip Code

United States
Country
Is your billing address different than your shipping address?
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Billing address (if different than shipping address)
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Billing Name (if different)
Street Address City State/Region/Province
Postal / Zip Code

United States
Country
Billing Email
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Billing Phone
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Do you want a glasses? *
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Yes
Have you worked with On Your Face Glasses before?
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-Select-
How did you find On Your Face Glasses?
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-Select-
Who referred you? We'd like to thank them.
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What is your occupation?
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What do you do for recreation and relaxation - sports, hobbies, etc.?
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What type(s) of glasses are you interested in?
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How will you use your new glasses?
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Have you worn prescription eyeglasses before?
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-Select-
What features of eyeglasses have worked well for you in the past?
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What features have worked not so well?
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Do you have vision insurance?
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-Select-
Name of insurance provider
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Your Vision
Please upload a copy of your most recent spectacles prescription here - an image of the entire page from your doctor. If you don't have it, no worries. Just skip to the next question.
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Upload file
Would you like a referral to a reputable eye doctor located near you?
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-Select-
Enter Zip Code(s)
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80210,80211,80212,...
Do you have your pupil distance (PD)?
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-Select-
PD - Right
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PD - Left
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Add the name and phone # of where you got the most recent pair of glasses that worked well for you.
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Do you wear UV-protective glasses when you're outside?
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-Select-
Are you interested in progressive lenses (to correct distance, mid-range and near vision, with no lines, in the same pair of lenses)?
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-Select-
Have you worn progressive lenses before?
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-Select-
The Fun Part: Your Style

Basics for Fitting You in Fabulous Frames
Size matters: please enter the size of your best-fitting frame. Even if it fits you terribly.
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Size is typically three numbers, e. g., 51-16-140, or 48 <square> 19 135, printed inside one of the temples/arms. If difficult to see, try photographing and enlarging. Please have that frame handy when we Zoom. Thank you!
Eye color
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-Select-
Skin tone - words are tough substitutes for pictures here; don't sweat this one.
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-Select-
Hair color (scroll down the choices to see them all)
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-Select-
Other (or more info about) Hair Color
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If you've had an image stylist analyze your colors, please upload pictures of your palette here.
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Upload file Capture image using webcam
Would you like a referral to a fabulous image stylist?
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-Select-
In what color clothes do you feel most fabulous?
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Help me understand you and your life, so I can help you best express who you are with your eyewear.
What—off the top of your head—are you passionate about?
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What in your life makes you feel most fulfilled (not necessarily eyeglasses-related)?
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List 4 words or short phrases that describe who you are at your deepest core. Think about descriptors you both embody and value most. Here are some words to jog your imagination:
1.
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2.
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3.
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4.
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Do you have any questions or concerns about your new glasses, or our process? Let's address them in the beginning, so your consultation yields the quickest and most fabulous results possible. I look forward to seeing you!
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Let the Eyewear Rumpus Begin!

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