Alternate Order Form

Please only fill this out if you have been instructed to do so. Thanks!

Please Tell us about yourself!

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Tell us About Your Doctor

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Used for sending the results of your HOME data to them and formal communication from MyEYES.
What does your doctor specialize in?

520 N Main Street, Suite C
Heber City, Utah 84032

Email (Preferred contact method)

Toll-free 1-833-5MY-EYES

**Due to Unusual High Call Volumes, we ask you to be patient. Typically we are able to respond within 24-48 Hours. If you need immediate help, please send us an email**


Hours of Operation: M-F  MST 10am-4pm