Print an Order Form

Before you send off your completed order form please ring me (Catherine) on 01253 795523 – as I may need to ask a couple of questions regarding eye measurements and lens choice.

To Print Your Order Form

There are two pages to the order form. Please print off both pages.

Please print off the front page from the click-able link shown above this image: 

Download (PDF, %ORDER FORM)



Please print off the back page from the click-able link shown above this image:

Download (PDF, %ORDER FORM)

If for any reason you have difficulty in downloading or printing out this order form, don’t worry, just contact Catherine by phone 01253 795 523 or email: and we’ll attach the order form for you on an email.

Complete this order form and wrap your glasses carefully and send:

  • Your prescription
  • Your completed order form
  • Your carefully wrapped glasses – please use plenty of bubble wrap (or similar)

Send to:

Reglaze Glasses
26 Greenhey
Lytham St Annes, FY8 4HL​