Order Contacts
Fill out this order form so we can evaluate your request. We will call you to confirm your payment method & order requirements. If you have any questions, please give us a call.
Full Name
Date of Birth (mm/dd/yyyy)
Phone (xxx-xxx-xxxx)
Email
Patient Status
Which eye(s) are you ordering contacts for

Vision Insurance Info (Optional)
Enter plan provider and your ID #
(Note: Medicaid does not cover contact lenses)
Notes
Enter Letters/Number you see:



OFFICE HOURS    
Mon
9:00 - 6:00
Tue
9:00 - 5:00
Wed
9:00 - 6:00
Thu
9:00 - 5:00
Fri
8:00 - 4:00
Sat
Closed
Sun
Closed
2151 Linglestown Rd.
Suite 110
Harrisburg, PA 17110
Map it!

(717) 657-5030
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Kirn Family Eye Care 2151 Linglestown Rd. Suite 110 Harrisburg, PA 17110 Phone: (717) 657-5030 Fax: (717) 657-5713

Kirn Family Eye Care is located in Harrisburg, PA and serves the towns of Summerdale, Lemoyne, Camp Hill, Dauphin, Enola, Marysville, New Cumberland, Mechanicsburg, Highspire, Hummelstown, Duncannon, New Buffalo, Etters, Middletown, New Kingstown, Halifax, and Hershey.

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