Formulaire de renouvellement de l'OrthoK NightFlex













Fitting phaseReorder

MorningEvening

Night/s

Month/s

Overrefration without CL








yesno

Overrefraction with CL (important in poor visual acuity)





Assessment




01234

noyes

normaltoo difficult

nonesmallLarge
Upload pictures/file max. 3mb (JPG, PNG, U12, ZCS, ZIP)





Fitting phaseReorder

MorningEvening

Night/s

Month/s

Overrefration without CL








yesno

Overrefraction with CL (important in poor visual acuity)





Assessment




01234

noyes

normaltoo difficult

nonesmallLarge
Upload pictures/file max. 3mb (JPG, PNG, U12, ZCS, ZIP)






Svp prouvez que vous êtes un humain en sélectionnant L'Avion.

preloader