MH OPTICAL FSV/STOCK ORDER FORM
Account Number
:
Account Name:
Email:
Lens Type
SPH
CYL
ADD
R/L Eye
QNTY (pieces)
Patient's Name
---None------------------------------------------------
---Same As Above----------------------------------
SV 1.50 UC 75mm----------------------------------
SV 1.50 UC 70mm----------------------------------
SV 1.50 UC 60mm----------------------------------
SV 1.50 UC 65mm----------------------------------
SV 1.50 UC 55mm----------------------------------
SV 1.50 HC Tintable 65/70mm------------------
SV 1.50 Basic AR 65/70---------------------------
SV 1.50 Premium AR 65/70---------------------
SV 1.50 Photo Grey--------------------------------
SV 1.50 Photo Brown-----------------------------
SV 1.50 Photo Grey AR---------------------------
SV 1.50 Photo Brown AR-------------------------
SV 1.50 Trans GS Grey----------------------------
SV 1.50 Trans GS Brown--------------------------
SV 1.50 Trans GS Grey Premium AR 65/70--
SV 1.50 Trans GS Brown Premium AR 65/70
SV 1.50 XtActive Grey 65/70--------------------
SV 1.50 Crizal Easy 65/70------------------------
SV 1.50 Crizal EasyPro 65/70--------------------
SV 1.50 Crizal Rock 65/70------------------------
SV 1.50 Crizal Prevencia 65/70-----------------
SV 1.50 Crizal Sapphire 65/70------------------
SV 1.50 Trans GS Grey EasyPro 65/70---------
SV 1.50 Trans GS Grey Rock 65/70-------------
SV 1.50 Trans GS Brown EasyPro 65/70------
SV 1.50 Trans GS Brown Rock 65/70----------
SV Poly 65/75---------------------------------------
SV Poly Tintable 65/75----------------------------
SV Poly Aspheric 65mm---------------------------
SV Poly Basic AR 65/72----------------------------
SV Poly Premium AR 65/72-----------------------
SV Poly 2.0 Safety 65/70--------------------------
SV Poly 2.0 Safety AR 65/70----------------------
SV Poly Blue Shield Clear 65/70-----------------
SV Poly Blue Shield Clear Premium AR 65/70
SV Poly Kodak Total Blue 65/70------------------
SV Poly Shore Blue Select AR---------------------
SV Poly Photo Grey 65/70-------------------------
SV Poly Photo Brown 65/70-----------------------
SV Poly Photo Grey AR 65/70---------------------
SV Poly Photo Brown AR 65/70-------------------
SV Poly Trans GS Grey 65/70----------------------
SV Poly Trans GS Brown 65/70--------------------
SV Poly Trans GS Grey Premium AR 65/70-----
SV Poly Trans GS Brown Premium AR 65/70--
SV Poly XTActive NG Grey 65/70-----------------
SV Poly Crizal Easy 65/70---------------------------
SV Poly Crizal EasyPro 65/70----------------------
SV Poly Crizal Rock 65/70---------------------------
SV Poly Crizal Prevencia 65/70--------------------
SV Poly Crizal Sapphire 65/70---------------------
SV Poly Trans GS Grey Rock 65/70---------------
SV Poly Trans GS Grey Sapphire 65/70----------
SV 1.56 SunSations Grey 65/70-------------------
SV 1.56 SunSations Grey AR 65/70--------------
SV 1.67 HC 65/70------------------------------------
SV 1.67 HC Tintable 65/70-------------------------
SV 1.67 Basic AR 65/70-----------------------------
SV 1.67 Premium AR 65/70------------------------
SV 1.67 Kodak Total Blue 65/70------------------
SV 1.67 Shore Blue 65/70--------------------------
SV 1.67 Trans GS Grey Premium AR 65/70----
SV 1.67 Crizal EasyPro 65/70---------------------
SV 1.67 Crizal Rock 65/70-------------------------
SV 1.67 Crizal Sapphire 65/70--------------------
SV 1.74 Basic AR 65/70----------------------------
SV 1.74 Super H AR 65/70------------------------
SV 1.74 Crizal Sapphire 65/70-------------------
SV 1.60 HC 65/70-----------------------------------
SV 1.60 Basic AR 65/70----------------------------
SV 1.60 Premium AR 65/70----------------------
SV Trivex HC 65/70---------------------------------
SV Trivex Premium AR-----------------------------
FT-28 1.50 UC 70mm-------------------------------
Progressive 1.50 UC 70mm-----------------------
Mini Progressive 1.50 UC 70mm----------------
SV 1.50 Plano Polar G-15 76mm----------------
SV Poly Plano Polar G-15 76mm----------------
PLANO
+0.25
+0.50
+0.75
+1.00
+1.25
+1.50
+1.75
+2.00
+2.25
+2.50
+2.75
+3.00
+3.25
+3.50
+3.75
+4.00
-0.25
-0.50
-0.75
-1.00
-1.25
-1.50
-1.75
-2.00
-2.25
-2.50
-2.75
-3.00
-3.25
-3.50
-3.75
-4.00
-4.25
-4.50
-4.75
-5.00
-5.25
-5.50
-5.75
-6.00
-6.25
-6.50
-6.75
-7.00
-7.25
-7.50
-7.75
-8.00
-8.25
-8.50
-8.75
-9.00
-9.25
-9.50
-9.75
-10.00
N/A
-0.25
-0.50
-0.75
-1.00
-1.25
-1.50
-1.75
-2.00
-2.25
-2.50
-2.75
-3.00
-3.25
-3.50
-3.75
-4.00
1.00
1.25
1.50
1.75
2.00
2.25
2.50
2.75
3.00
N/A
N/A
Right
Left
Pair
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
---None------------------------------------------------
---Same As Above----------------------------------
SV 1.50 UC 75mm----------------------------------
SV 1.50 UC 70mm----------------------------------
SV 1.50 UC 60mm----------------------------------
SV 1.50 UC 65mm----------------------------------
SV 1.50 UC 55mm----------------------------------
SV 1.50 HC Tintable 65/70mm------------------
SV 1.50 Basic AR 65/70---------------------------
SV 1.50 Premium AR 65/70---------------------
SV 1.50 Photo Grey--------------------------------
SV 1.50 Photo Brown-----------------------------
SV 1.50 Photo Grey AR---------------------------
SV 1.50 Photo Brown AR-------------------------
SV 1.50 Trans GS Grey----------------------------
SV 1.50 Trans GS Brown--------------------------
SV 1.50 Trans GS Grey Premium AR 65/70--
SV 1.50 Trans GS Brown Premium AR 65/70
SV 1.50 XtActive Grey 65/70--------------------
SV 1.50 Crizal Easy 65/70------------------------
SV 1.50 Crizal EasyPro 65/70--------------------
SV 1.50 Crizal Rock 65/70------------------------
SV 1.50 Crizal Prevencia 65/70-----------------
SV 1.50 Crizal Sapphire 65/70------------------
SV 1.50 Trans GS Grey EasyPro 65/70---------
SV 1.50 Trans GS Grey Rock 65/70-------------
SV 1.50 Trans GS Brown EasyPro 65/70------
SV 1.50 Trans GS Brown Rock 65/70----------
SV Poly 65/75---------------------------------------
SV Poly Tintable 65/75----------------------------
SV Poly Aspheric 65mm---------------------------
SV Poly Basic AR 65/72----------------------------
SV Poly Premium AR 65/72-----------------------
SV Poly 2.0 Safety 65/70--------------------------
SV Poly 2.0 Safety AR 65/70----------------------
SV Poly Blue Shield Clear 65/70-----------------
SV Poly Blue Shield Clear Premium AR 65/70
SV Poly Kodak Total Blue 65/70------------------
SV Poly Shore Blue Select AR---------------------
SV Poly Photo Grey 65/70-------------------------
SV Poly Photo Brown 65/70-----------------------
SV Poly Photo Grey AR 65/70---------------------
SV Poly Photo Brown AR 65/70-------------------
SV Poly Trans GS Grey 65/70----------------------
SV Poly Trans GS Brown 65/70--------------------
SV Poly Trans GS Grey Premium AR 65/70-----
SV Poly Trans GS Brown Premium AR 65/70--
SV Poly XTActive NG Grey 65/70-----------------
SV Poly Crizal Easy 65/70---------------------------
SV Poly Crizal EasyPro 65/70----------------------
SV Poly Crizal Rock 65/70---------------------------
SV Poly Crizal Prevencia 65/70--------------------
SV Poly Crizal Sapphire 65/70---------------------
SV Poly Trans GS Grey Rock 65/70---------------
SV Poly Trans GS Grey Sapphire 65/70----------
SV 1.56 SunSations Grey 65/70-------------------
SV 1.56 SunSations Grey AR 65/70--------------
SV 1.67 HC 65/70------------------------------------
SV 1.67 HC Tintable 65/70-------------------------
SV 1.67 Basic AR 65/70-----------------------------
SV 1.67 Premium AR 65/70------------------------
SV 1.67 Kodak Total Blue 65/70------------------
SV 1.67 Shore Blue 65/70--------------------------
SV 1.67 Trans GS Grey Premium AR 65/70----
SV 1.67 Crizal EasyPro 65/70---------------------
SV 1.67 Crizal Rock 65/70-------------------------
SV 1.67 Crizal Sapphire 65/70--------------------
SV 1.74 Basic AR 65/70----------------------------
SV 1.74 Super H AR 65/70------------------------
SV 1.74 Crizal Sapphire 65/70-------------------
SV 1.60 HC 65/70-----------------------------------
SV 1.60 Basic AR 65/70----------------------------
SV 1.60 Premium AR 65/70----------------------
SV Trivex HC 65/70---------------------------------
SV Trivex Premium AR-----------------------------
FT-28 1.50 UC 70mm-------------------------------
Progressive 1.50 UC 70mm-----------------------
Mini Progressive 1.50 UC 70mm----------------
SV 1.50 Plano Polar G-15 76mm----------------
SV Poly Plano Polar G-15 76mm----------------
PLANO
+0.25
+0.50
+0.75
+1.00
+1.25
+1.50
+1.75
+2.00
+2.25
+2.50
+2.75
+3.00
+3.25
+3.50
+3.75
+4.00
-0.25
-0.50
-0.75
-1.00
-1.25
-1.50
-1.75
-2.00
-2.25
-2.50
-2.75
-3.00
-3.25
-3.50
-3.75
-4.00
-4.25
-4.50
-4.75
-5.00
-5.25
-5.50
-5.75
-6.00
-6.25
-6.50
-6.75
-7.00
-7.25
-7.50
-7.75
-8.00
-8.25
-8.50
-8.75
-9.00
-9.25
-9.50
-9.75
-10.00
N/A
-0.25
-0.50
-0.75
-1.00
-1.25
-1.50
-1.75
-2.00
-2.25
-2.50
-2.75
-3.00
-3.25
-3.50
-3.75
-4.00
1.00
1.25
1.50
1.75
2.00
2.25
2.50
2.75
3.00
N/A
N/A
Right
Left
Pair
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
---None------------------------------------------------
---Same As Above----------------------------------
SV 1.50 UC 75mm----------------------------------
SV 1.50 UC 70mm----------------------------------
SV 1.50 UC 60mm----------------------------------
SV 1.50 UC 65mm----------------------------------
SV 1.50 UC 55mm----------------------------------
SV 1.50 HC Tintable 65/70mm------------------
SV 1.50 Basic AR 65/70---------------------------
SV 1.50 Premium AR 65/70---------------------
SV 1.50 Photo Grey--------------------------------
SV 1.50 Photo Brown-----------------------------
SV 1.50 Photo Grey AR---------------------------
SV 1.50 Photo Brown AR-------------------------
SV 1.50 Trans GS Grey----------------------------
SV 1.50 Trans GS Brown--------------------------
SV 1.50 Trans GS Grey Premium AR 65/70--
SV 1.50 Trans GS Brown Premium AR 65/70
SV 1.50 XtActive Grey 65/70--------------------
SV 1.50 Crizal Easy 65/70------------------------
SV 1.50 Crizal EasyPro 65/70--------------------
SV 1.50 Crizal Rock 65/70------------------------
SV 1.50 Crizal Prevencia 65/70-----------------
SV 1.50 Crizal Sapphire 65/70------------------
SV 1.50 Trans GS Grey EasyPro 65/70---------
SV 1.50 Trans GS Grey Rock 65/70-------------
SV 1.50 Trans GS Brown EasyPro 65/70------
SV 1.50 Trans GS Brown Rock 65/70----------
SV Poly 65/75---------------------------------------
SV Poly Tintable 65/75----------------------------
SV Poly Aspheric 65mm---------------------------
SV Poly Basic AR 65/72----------------------------
SV Poly Premium AR 65/72-----------------------
SV Poly 2.0 Safety 65/70--------------------------
SV Poly 2.0 Safety AR 65/70----------------------
SV Poly Blue Shield Clear 65/70-----------------
SV Poly Blue Shield Clear Premium AR 65/70
SV Poly Kodak Total Blue 65/70------------------
SV Poly Shore Blue Select AR---------------------
SV Poly Photo Grey 65/70-------------------------
SV Poly Photo Brown 65/70-----------------------
SV Poly Photo Grey AR 65/70---------------------
SV Poly Photo Brown AR 65/70-------------------
SV Poly Trans GS Grey 65/70----------------------
SV Poly Trans GS Brown 65/70--------------------
SV Poly Trans GS Grey Premium AR 65/70-----
SV Poly Trans GS Brown Premium AR 65/70--
SV Poly XTActive NG Grey 65/70-----------------
SV Poly Crizal Easy 65/70---------------------------
SV Poly Crizal EasyPro 65/70----------------------
SV Poly Crizal Rock 65/70---------------------------
SV Poly Crizal Prevencia 65/70--------------------
SV Poly Crizal Sapphire 65/70---------------------
SV Poly Trans GS Grey Rock 65/70---------------
SV Poly Trans GS Grey Sapphire 65/70----------
SV 1.56 SunSations Grey 65/70-------------------
SV 1.56 SunSations Grey AR 65/70--------------
SV 1.67 HC 65/70------------------------------------
SV 1.67 HC Tintable 65/70-------------------------
SV 1.67 Basic AR 65/70-----------------------------
SV 1.67 Premium AR 65/70------------------------
SV 1.67 Kodak Total Blue 65/70------------------
SV 1.67 Shore Blue 65/70--------------------------
SV 1.67 Trans GS Grey Premium AR 65/70----
SV 1.67 Crizal EasyPro 65/70---------------------
SV 1.67 Crizal Rock 65/70-------------------------
SV 1.67 Crizal Sapphire 65/70--------------------
SV 1.74 Basic AR 65/70----------------------------
SV 1.74 Super H AR 65/70------------------------
SV 1.74 Crizal Sapphire 65/70-------------------
SV 1.60 HC 65/70-----------------------------------
SV 1.60 Basic AR 65/70----------------------------
SV 1.60 Premium AR 65/70----------------------
SV Trivex HC 65/70---------------------------------
SV Trivex Premium AR-----------------------------
FT-28 1.50 UC 70mm-------------------------------
Progressive 1.50 UC 70mm-----------------------
Mini Progressive 1.50 UC 70mm----------------
SV 1.50 Plano Polar G-15 76mm----------------
SV Poly Plano Polar G-15 76mm----------------
PLANO
+0.25
+0.50
+0.75
+1.00
+1.25
+1.50
+1.75
+2.00
+2.25
+2.50
+2.75
+3.00
+3.25
+3.50
+3.75
+4.00
-0.25
-0.50
-0.75
-1.00
-1.25
-1.50
-1.75
-2.00
-2.25
-2.50
-2.75
-3.00
-3.25
-3.50
-3.75
-4.00
-4.25
-4.50
-4.75
-5.00
-5.25
-5.50
-5.75
-6.00
-6.25
-6.50
-6.75
-7.00
-7.25
-7.50
-7.75
-8.00
-8.25
-8.50
-8.75
-9.00
-9.25
-9.50
-9.75
-10.00
N/A
-0.25
-0.50
-0.75
-1.00
-1.25
-1.50
-1.75
-2.00
-2.25
-2.50
-2.75
-3.00
-3.25
-3.50
-3.75
-4.00
1.00
1.25
1.50
1.75
2.00
2.25
2.50
2.75
3.00
N/A
N/A
Right
Left
Pair
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
---None------------------------------------------------
---Same As Above----------------------------------
SV 1.50 UC 75mm----------------------------------
SV 1.50 UC 70mm----------------------------------
SV 1.50 UC 60mm----------------------------------
SV 1.50 UC 65mm----------------------------------
SV 1.50 UC 55mm----------------------------------
SV 1.50 HC Tintable 65/70mm------------------
SV 1.50 Basic AR 65/70---------------------------
SV 1.50 Premium AR 65/70---------------------
SV 1.50 Photo Grey--------------------------------
SV 1.50 Photo Brown-----------------------------
SV 1.50 Photo Grey AR---------------------------
SV 1.50 Photo Brown AR-------------------------
SV 1.50 Trans GS Grey----------------------------
SV 1.50 Trans GS Brown--------------------------
SV 1.50 Trans GS Grey Premium AR 65/70--
SV 1.50 Trans GS Brown Premium AR 65/70
SV 1.50 XtActive Grey 65/70--------------------
SV 1.50 Crizal Easy 65/70------------------------
SV 1.50 Crizal EasyPro 65/70--------------------
SV 1.50 Crizal Rock 65/70------------------------
SV 1.50 Crizal Prevencia 65/70-----------------
SV 1.50 Crizal Sapphire 65/70------------------
SV 1.50 Trans GS Grey EasyPro 65/70---------
SV 1.50 Trans GS Grey Rock 65/70-------------
SV 1.50 Trans GS Brown EasyPro 65/70------
SV 1.50 Trans GS Brown Rock 65/70----------
SV Poly 65/75---------------------------------------
SV Poly Tintable 65/75----------------------------
SV Poly Aspheric 65mm---------------------------
SV Poly Basic AR 65/72----------------------------
SV Poly Premium AR 65/72-----------------------
SV Poly 2.0 Safety 65/70--------------------------
SV Poly 2.0 Safety AR 65/70----------------------
SV Poly Blue Shield Clear 65/70-----------------
SV Poly Blue Shield Clear Premium AR 65/70
SV Poly Kodak Total Blue 65/70------------------
SV Poly Shore Blue Select AR---------------------
SV Poly Photo Grey 65/70-------------------------
SV Poly Photo Brown 65/70-----------------------
SV Poly Photo Grey AR 65/70---------------------
SV Poly Photo Brown AR 65/70-------------------
SV Poly Trans GS Grey 65/70----------------------
SV Poly Trans GS Brown 65/70--------------------
SV Poly Trans GS Grey Premium AR 65/70-----
SV Poly Trans GS Brown Premium AR 65/70--
SV Poly XTActive NG Grey 65/70-----------------
SV Poly Crizal Easy 65/70---------------------------
SV Poly Crizal EasyPro 65/70----------------------
SV Poly Crizal Rock 65/70---------------------------
SV Poly Crizal Prevencia 65/70--------------------
SV Poly Crizal Sapphire 65/70---------------------
SV Poly Trans GS Grey Rock 65/70---------------
SV Poly Trans GS Grey Sapphire 65/70----------
SV 1.56 SunSations Grey 65/70-------------------
SV 1.56 SunSations Grey AR 65/70--------------
SV 1.67 HC 65/70------------------------------------
SV 1.67 HC Tintable 65/70-------------------------
SV 1.67 Basic AR 65/70-----------------------------
SV 1.67 Premium AR 65/70------------------------
SV 1.67 Kodak Total Blue 65/70------------------
SV 1.67 Shore Blue 65/70--------------------------
SV 1.67 Trans GS Grey Premium AR 65/70----
SV 1.67 Crizal EasyPro 65/70---------------------
SV 1.67 Crizal Rock 65/70-------------------------
SV 1.67 Crizal Sapphire 65/70--------------------
SV 1.74 Basic AR 65/70----------------------------
SV 1.74 Super H AR 65/70------------------------
SV 1.74 Crizal Sapphire 65/70-------------------
SV 1.60 HC 65/70-----------------------------------
SV 1.60 Basic AR 65/70----------------------------
SV 1.60 Premium AR 65/70----------------------
SV Trivex HC 65/70---------------------------------
SV Trivex Premium AR-----------------------------
FT-28 1.50 UC 70mm-------------------------------
Progressive 1.50 UC 70mm-----------------------
Mini Progressive 1.50 UC 70mm----------------
SV 1.50 Plano Polar G-15 76mm----------------
SV Poly Plano Polar G-15 76mm----------------
PLANO
+0.25
+0.50
+0.75
+1.00
+1.25
+1.50
+1.75
+2.00
+2.25
+2.50
+2.75
+3.00
+3.25
+3.50
+3.75
+4.00
-0.25
-0.50
-0.75
-1.00
-1.25
-1.50
-1.75
-2.00
-2.25
-2.50
-2.75
-3.00
-3.25
-3.50
-3.75
-4.00
-4.25
-4.50
-4.75
-5.00
-5.25
-5.50
-5.75
-6.00
-6.25
-6.50
-6.75
-7.00
-7.25
-7.50
-7.75
-8.00
-8.25
-8.50
-8.75
-9.00
-9.25
-9.50
-9.75
-10.00
N/A
-0.25
-0.50
-0.75
-1.00
-1.25
-1.50
-1.75
-2.00
-2.25
-2.50
-2.75
-3.00
-3.25
-3.50
-3.75
-4.00
1.00
1.25
1.50
1.75
2.00
2.25
2.50
2.75
3.00
N/A
N/A
Right
Left
Pair
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
---None------------------------------------------------
---Same As Above----------------------------------
SV 1.50 UC 75mm----------------------------------
SV 1.50 UC 70mm----------------------------------
SV 1.50 UC 60mm----------------------------------
SV 1.50 UC 65mm----------------------------------
SV 1.50 UC 55mm----------------------------------
SV 1.50 HC Tintable 65/70mm------------------
SV 1.50 Basic AR 65/70---------------------------
SV 1.50 Premium AR 65/70---------------------
SV 1.50 Photo Grey--------------------------------
SV 1.50 Photo Brown-----------------------------
SV 1.50 Photo Grey AR---------------------------
SV 1.50 Photo Brown AR-------------------------
SV 1.50 Trans GS Grey----------------------------
SV 1.50 Trans GS Brown--------------------------
SV 1.50 Trans GS Grey Premium AR 65/70--
SV 1.50 Trans GS Brown Premium AR 65/70
SV 1.50 XtActive Grey 65/70--------------------
SV 1.50 Crizal Easy 65/70------------------------
SV 1.50 Crizal EasyPro 65/70--------------------
SV 1.50 Crizal Rock 65/70------------------------
SV 1.50 Crizal Prevencia 65/70-----------------
SV 1.50 Crizal Sapphire 65/70------------------
SV 1.50 Trans GS Grey EasyPro 65/70---------
SV 1.50 Trans GS Grey Rock 65/70-------------
SV 1.50 Trans GS Brown EasyPro 65/70------
SV 1.50 Trans GS Brown Rock 65/70----------
SV Poly 65/75---------------------------------------
SV Poly Tintable 65/75----------------------------
SV Poly Aspheric 65mm---------------------------
SV Poly Basic AR 65/72----------------------------
SV Poly Premium AR 65/72-----------------------
SV Poly 2.0 Safety 65/70--------------------------
SV Poly 2.0 Safety AR 65/70----------------------
SV Poly Blue Shield Clear 65/70-----------------
SV Poly Blue Shield Clear Premium AR 65/70
SV Poly Kodak Total Blue 65/70------------------
SV Poly Shore Blue Select AR---------------------
SV Poly Photo Grey 65/70-------------------------
SV Poly Photo Brown 65/70-----------------------
SV Poly Photo Grey AR 65/70---------------------
SV Poly Photo Brown AR 65/70-------------------
SV Poly Trans GS Grey 65/70----------------------
SV Poly Trans GS Brown 65/70--------------------
SV Poly Trans GS Grey Premium AR 65/70-----
SV Poly Trans GS Brown Premium AR 65/70--
SV Poly XTActive NG Grey 65/70-----------------
SV Poly Crizal Easy 65/70---------------------------
SV Poly Crizal EasyPro 65/70----------------------
SV Poly Crizal Rock 65/70---------------------------
SV Poly Crizal Prevencia 65/70--------------------
SV Poly Crizal Sapphire 65/70---------------------
SV Poly Trans GS Grey Rock 65/70---------------
SV Poly Trans GS Grey Sapphire 65/70----------
SV 1.56 SunSations Grey 65/70-------------------
SV 1.56 SunSations Grey AR 65/70--------------
SV 1.67 HC 65/70------------------------------------
SV 1.67 HC Tintable 65/70-------------------------
SV 1.67 Basic AR 65/70-----------------------------
SV 1.67 Premium AR 65/70------------------------
SV 1.67 Kodak Total Blue 65/70------------------
SV 1.67 Shore Blue 65/70--------------------------
SV 1.67 Trans GS Grey Premium AR 65/70----
SV 1.67 Crizal EasyPro 65/70---------------------
SV 1.67 Crizal Rock 65/70-------------------------
SV 1.67 Crizal Sapphire 65/70--------------------
SV 1.74 Basic AR 65/70----------------------------
SV 1.74 Super H AR 65/70------------------------
SV 1.74 Crizal Sapphire 65/70-------------------
SV 1.60 HC 65/70-----------------------------------
SV 1.60 Basic AR 65/70----------------------------
SV 1.60 Premium AR 65/70----------------------
SV Trivex HC 65/70---------------------------------
SV Trivex Premium AR-----------------------------
FT-28 1.50 UC 70mm-------------------------------
Progressive 1.50 UC 70mm-----------------------
Mini Progressive 1.50 UC 70mm----------------
SV 1.50 Plano Polar G-15 76mm----------------
SV Poly Plano Polar G-15 76mm----------------
PLANO
+0.25
+0.50
+0.75
+1.00
+1.25
+1.50
+1.75
+2.00
+2.25
+2.50
+2.75
+3.00
+3.25
+3.50
+3.75
+4.00
-0.25
-0.50
-0.75
-1.00
-1.25
-1.50
-1.75
-2.00
-2.25
-2.50
-2.75
-3.00
-3.25
-3.50
-3.75
-4.00
-4.25
-4.50
-4.75
-5.00
-5.25
-5.50
-5.75
-6.00
-6.25
-6.50
-6.75
-7.00
-7.25
-7.50
-7.75
-8.00
-8.25
-8.50
-8.75
-9.00
-9.25
-9.50
-9.75
-10.00
N/A
-0.25
-0.50
-0.75
-1.00
-1.25
-1.50
-1.75
-2.00
-2.25
-2.50
-2.75
-3.00
-3.25
-3.50
-3.75
-4.00
1.00
1.25
1.50
1.75
2.00
2.25
2.50
2.75
3.00
N/A
N/A
Right
Left
Pair
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
---None------------------------------------------------
---Same As Above----------------------------------
SV 1.50 UC 75mm----------------------------------
SV 1.50 UC 70mm----------------------------------
SV 1.50 UC 60mm----------------------------------
SV 1.50 UC 65mm----------------------------------
SV 1.50 UC 55mm----------------------------------
SV 1.50 HC Tintable 65/70mm------------------
SV 1.50 Basic AR 65/70---------------------------
SV 1.50 Premium AR 65/70---------------------
SV 1.50 Photo Grey--------------------------------
SV 1.50 Photo Brown-----------------------------
SV 1.50 Photo Grey AR---------------------------
SV 1.50 Photo Brown AR-------------------------
SV 1.50 Trans GS Grey----------------------------
SV 1.50 Trans GS Brown--------------------------
SV 1.50 Trans GS Grey Premium AR 65/70--
SV 1.50 Trans GS Brown Premium AR 65/70
SV 1.50 XtActive Grey 65/70--------------------
SV 1.50 Crizal Easy 65/70------------------------
SV 1.50 Crizal EasyPro 65/70--------------------
SV 1.50 Crizal Rock 65/70------------------------
SV 1.50 Crizal Prevencia 65/70-----------------
SV 1.50 Crizal Sapphire 65/70------------------
SV 1.50 Trans GS Grey EasyPro 65/70---------
SV 1.50 Trans GS Grey Rock 65/70-------------
SV 1.50 Trans GS Brown EasyPro 65/70------
SV 1.50 Trans GS Brown Rock 65/70----------
SV Poly 65/75---------------------------------------
SV Poly Tintable 65/75----------------------------
SV Poly Aspheric 65mm---------------------------
SV Poly Basic AR 65/72----------------------------
SV Poly Premium AR 65/72-----------------------
SV Poly 2.0 Safety 65/70--------------------------
SV Poly 2.0 Safety AR 65/70----------------------
SV Poly Blue Shield Clear 65/70-----------------
SV Poly Blue Shield Clear Premium AR 65/70
SV Poly Kodak Total Blue 65/70------------------
SV Poly Shore Blue Select AR---------------------
SV Poly Photo Grey 65/70-------------------------
SV Poly Photo Brown 65/70-----------------------
SV Poly Photo Grey AR 65/70---------------------
SV Poly Photo Brown AR 65/70-------------------
SV Poly Trans GS Grey 65/70----------------------
SV Poly Trans GS Brown 65/70--------------------
SV Poly Trans GS Grey Premium AR 65/70-----
SV Poly Trans GS Brown Premium AR 65/70--
SV Poly XTActive NG Grey 65/70-----------------
SV Poly Crizal Easy 65/70---------------------------
SV Poly Crizal EasyPro 65/70----------------------
SV Poly Crizal Rock 65/70---------------------------
SV Poly Crizal Prevencia 65/70--------------------
SV Poly Crizal Sapphire 65/70---------------------
SV Poly Trans GS Grey Rock 65/70---------------
SV Poly Trans GS Grey Sapphire 65/70----------
SV 1.56 SunSations Grey 65/70-------------------
SV 1.56 SunSations Grey AR 65/70--------------
SV 1.67 HC 65/70------------------------------------
SV 1.67 HC Tintable 65/70-------------------------
SV 1.67 Basic AR 65/70-----------------------------
SV 1.67 Premium AR 65/70------------------------
SV 1.67 Kodak Total Blue 65/70------------------
SV 1.67 Shore Blue 65/70--------------------------
SV 1.67 Trans GS Grey Premium AR 65/70----
SV 1.67 Crizal EasyPro 65/70---------------------
SV 1.67 Crizal Rock 65/70-------------------------
SV 1.67 Crizal Sapphire 65/70--------------------
SV 1.74 Basic AR 65/70----------------------------
SV 1.74 Super H AR 65/70------------------------
SV 1.74 Crizal Sapphire 65/70-------------------
SV 1.60 HC 65/70-----------------------------------
SV 1.60 Basic AR 65/70----------------------------
SV 1.60 Premium AR 65/70----------------------
SV Trivex HC 65/70---------------------------------
SV Trivex Premium AR-----------------------------
FT-28 1.50 UC 70mm-------------------------------
Progressive 1.50 UC 70mm-----------------------
Mini Progressive 1.50 UC 70mm----------------
SV 1.50 Plano Polar G-15 76mm----------------
SV Poly Plano Polar G-15 76mm----------------
PLANO
+0.25
+0.50
+0.75
+1.00
+1.25
+1.50
+1.75
+2.00
+2.25
+2.50
+2.75
+3.00
+3.25
+3.50
+3.75
+4.00
-0.25
-0.50
-0.75
-1.00
-1.25
-1.50
-1.75
-2.00
-2.25
-2.50
-2.75
-3.00
-3.25
-3.50
-3.75
-4.00
-4.25
-4.50
-4.75
-5.00
-5.25
-5.50
-5.75
-6.00
-6.25
-6.50
-6.75
-7.00
-7.25
-7.50
-7.75
-8.00
-8.25
-8.50
-8.75
-9.00
-9.25
-9.50
-9.75
-10.00
N/A
-0.25
-0.50
-0.75
-1.00
-1.25
-1.50
-1.75
-2.00
-2.25
-2.50
-2.75
-3.00
-3.25
-3.50
-3.75
-4.00
1.00
1.25
1.50
1.75
2.00
2.25
2.50
2.75
3.00
N/A
N/A
Right
Left
Pair
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
---None------------------------------------------------
---Same As Above----------------------------------
SV 1.50 UC 75mm----------------------------------
SV 1.50 UC 70mm----------------------------------
SV 1.50 UC 60mm----------------------------------
SV 1.50 UC 65mm----------------------------------
SV 1.50 UC 55mm----------------------------------
SV 1.50 HC Tintable 65/70mm------------------
SV 1.50 Basic AR 65/70---------------------------
SV 1.50 Premium AR 65/70---------------------
SV 1.50 Photo Grey--------------------------------
SV 1.50 Photo Brown-----------------------------
SV 1.50 Photo Grey AR---------------------------
SV 1.50 Photo Brown AR-------------------------
SV 1.50 Trans GS Grey----------------------------
SV 1.50 Trans GS Brown--------------------------
SV 1.50 Trans GS Grey Premium AR 65/70--
SV 1.50 Trans GS Brown Premium AR 65/70
SV 1.50 XtActive Grey 65/70--------------------
SV 1.50 Crizal Easy 65/70------------------------
SV 1.50 Crizal EasyPro 65/70--------------------
SV 1.50 Crizal Rock 65/70------------------------
SV 1.50 Crizal Prevencia 65/70-----------------
SV 1.50 Crizal Sapphire 65/70------------------
SV 1.50 Trans GS Grey EasyPro 65/70---------
SV 1.50 Trans GS Grey Rock 65/70-------------
SV 1.50 Trans GS Brown EasyPro 65/70------
SV 1.50 Trans GS Brown Rock 65/70----------
SV Poly 65/75---------------------------------------
SV Poly Tintable 65/75----------------------------
SV Poly Aspheric 65mm---------------------------
SV Poly Basic AR 65/72----------------------------
SV Poly Premium AR 65/72-----------------------
SV Poly 2.0 Safety 65/70--------------------------
SV Poly 2.0 Safety AR 65/70----------------------
SV Poly Blue Shield Clear 65/70-----------------
SV Poly Blue Shield Clear Premium AR 65/70
SV Poly Kodak Total Blue 65/70------------------
SV Poly Shore Blue Select AR---------------------
SV Poly Photo Grey 65/70-------------------------
SV Poly Photo Brown 65/70-----------------------
SV Poly Photo Grey AR 65/70---------------------
SV Poly Photo Brown AR 65/70-------------------
SV Poly Trans GS Grey 65/70----------------------
SV Poly Trans GS Brown 65/70--------------------
SV Poly Trans GS Grey Premium AR 65/70-----
SV Poly Trans GS Brown Premium AR 65/70--
SV Poly XTActive NG Grey 65/70-----------------
SV Poly Crizal Easy 65/70---------------------------
SV Poly Crizal EasyPro 65/70----------------------
SV Poly Crizal Rock 65/70---------------------------
SV Poly Crizal Prevencia 65/70--------------------
SV Poly Crizal Sapphire 65/70---------------------
SV Poly Trans GS Grey Rock 65/70---------------
SV Poly Trans GS Grey Sapphire 65/70----------
SV 1.56 SunSations Grey 65/70-------------------
SV 1.56 SunSations Grey AR 65/70--------------
SV 1.67 HC 65/70------------------------------------
SV 1.67 HC Tintable 65/70-------------------------
SV 1.67 Basic AR 65/70-----------------------------
SV 1.67 Premium AR 65/70------------------------
SV 1.67 Kodak Total Blue 65/70------------------
SV 1.67 Shore Blue 65/70--------------------------
SV 1.67 Trans GS Grey Premium AR 65/70----
SV 1.67 Crizal EasyPro 65/70---------------------
SV 1.67 Crizal Rock 65/70-------------------------
SV 1.67 Crizal Sapphire 65/70--------------------
SV 1.74 Basic AR 65/70----------------------------
SV 1.74 Super H AR 65/70------------------------
SV 1.74 Crizal Sapphire 65/70-------------------
SV 1.60 HC 65/70-----------------------------------
SV 1.60 Basic AR 65/70----------------------------
SV 1.60 Premium AR 65/70----------------------
SV Trivex HC 65/70---------------------------------
SV Trivex Premium AR-----------------------------
FT-28 1.50 UC 70mm-------------------------------
Progressive 1.50 UC 70mm-----------------------
Mini Progressive 1.50 UC 70mm----------------
SV 1.50 Plano Polar G-15 76mm----------------
SV Poly Plano Polar G-15 76mm----------------
PLANO
+0.25
+0.50
+0.75
+1.00
+1.25
+1.50
+1.75
+2.00
+2.25
+2.50
+2.75
+3.00
+3.25
+3.50
+3.75
+4.00
-0.25
-0.50
-0.75
-1.00
-1.25
-1.50
-1.75
-2.00
-2.25
-2.50
-2.75
-3.00
-3.25
-3.50
-3.75
-4.00
-4.25
-4.50
-4.75
-5.00
-5.25
-5.50
-5.75
-6.00
-6.25
-6.50
-6.75
-7.00
-7.25
-7.50
-7.75
-8.00
-8.25
-8.50
-8.75
-9.00
-9.25
-9.50
-9.75
-10.00
N/A
-0.25
-0.50
-0.75
-1.00
-1.25
-1.50
-1.75
-2.00
-2.25
-2.50
-2.75
-3.00
-3.25
-3.50
-3.75
-4.00
1.00
1.25
1.50
1.75
2.00
2.25
2.50
2.75
3.00
N/A
N/A
Right
Left
Pair
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
---None------------------------------------------------
---Same As Above----------------------------------
SV 1.50 UC 75mm----------------------------------
SV 1.50 UC 70mm----------------------------------
SV 1.50 UC 60mm----------------------------------
SV 1.50 UC 65mm----------------------------------
SV 1.50 UC 55mm----------------------------------
SV 1.50 HC Tintable 65/70mm------------------
SV 1.50 Basic AR 65/70---------------------------
SV 1.50 Premium AR 65/70---------------------
SV 1.50 Photo Grey--------------------------------
SV 1.50 Photo Brown-----------------------------
SV 1.50 Photo Grey AR---------------------------
SV 1.50 Photo Brown AR-------------------------
SV 1.50 Trans GS Grey----------------------------
SV 1.50 Trans GS Brown--------------------------
SV 1.50 Trans GS Grey Premium AR 65/70--
SV 1.50 Trans GS Brown Premium AR 65/70
SV 1.50 XtActive Grey 65/70--------------------
SV 1.50 Crizal Easy 65/70------------------------
SV 1.50 Crizal EasyPro 65/70--------------------
SV 1.50 Crizal Rock 65/70------------------------
SV 1.50 Crizal Prevencia 65/70-----------------
SV 1.50 Crizal Sapphire 65/70------------------
SV 1.50 Trans GS Grey EasyPro 65/70---------
SV 1.50 Trans GS Grey Rock 65/70-------------
SV 1.50 Trans GS Brown EasyPro 65/70------
SV 1.50 Trans GS Brown Rock 65/70----------
SV Poly 65/75---------------------------------------
SV Poly Tintable 65/75----------------------------
SV Poly Aspheric 65mm---------------------------
SV Poly Basic AR 65/72----------------------------
SV Poly Premium AR 65/72-----------------------
SV Poly 2.0 Safety 65/70--------------------------
SV Poly 2.0 Safety AR 65/70----------------------
SV Poly Blue Shield Clear 65/70-----------------
SV Poly Blue Shield Clear Premium AR 65/70
SV Poly Kodak Total Blue 65/70------------------
SV Poly Shore Blue Select AR---------------------
SV Poly Photo Grey 65/70-------------------------
SV Poly Photo Brown 65/70-----------------------
SV Poly Photo Grey AR 65/70---------------------
SV Poly Photo Brown AR 65/70-------------------
SV Poly Trans GS Grey 65/70----------------------
SV Poly Trans GS Brown 65/70--------------------
SV Poly Trans GS Grey Premium AR 65/70-----
SV Poly Trans GS Brown Premium AR 65/70--
SV Poly XTActive NG Grey 65/70-----------------
SV Poly Crizal Easy 65/70---------------------------
SV Poly Crizal EasyPro 65/70----------------------
SV Poly Crizal Rock 65/70---------------------------
SV Poly Crizal Prevencia 65/70--------------------
SV Poly Crizal Sapphire 65/70---------------------
SV Poly Trans GS Grey Rock 65/70---------------
SV Poly Trans GS Grey Sapphire 65/70----------
SV 1.56 SunSations Grey 65/70-------------------
SV 1.56 SunSations Grey AR 65/70--------------
SV 1.67 HC 65/70------------------------------------
SV 1.67 HC Tintable 65/70-------------------------
SV 1.67 Basic AR 65/70-----------------------------
SV 1.67 Premium AR 65/70------------------------
SV 1.67 Kodak Total Blue 65/70------------------
SV 1.67 Shore Blue 65/70--------------------------
SV 1.67 Trans GS Grey Premium AR 65/70----
SV 1.67 Crizal EasyPro 65/70---------------------
SV 1.67 Crizal Rock 65/70-------------------------
SV 1.67 Crizal Sapphire 65/70--------------------
SV 1.74 Basic AR 65/70----------------------------
SV 1.74 Super H AR 65/70------------------------
SV 1.74 Crizal Sapphire 65/70-------------------
SV 1.60 HC 65/70-----------------------------------
SV 1.60 Basic AR 65/70----------------------------
SV 1.60 Premium AR 65/70----------------------
SV Trivex HC 65/70---------------------------------
SV Trivex Premium AR-----------------------------
FT-28 1.50 UC 70mm-------------------------------
Progressive 1.50 UC 70mm-----------------------
Mini Progressive 1.50 UC 70mm----------------
SV 1.50 Plano Polar G-15 76mm----------------
SV Poly Plano Polar G-15 76mm----------------
PLANO
+0.25
+0.50
+0.75
+1.00
+1.25
+1.50
+1.75
+2.00
+2.25
+2.50
+2.75
+3.00
+3.25
+3.50
+3.75
+4.00
-0.25
-0.50
-0.75
-1.00
-1.25
-1.50
-1.75
-2.00
-2.25
-2.50
-2.75
-3.00
-3.25
-3.50
-3.75
-4.00
-4.25
-4.50
-4.75
-5.00
-5.25
-5.50
-5.75
-6.00
-6.25
-6.50
-6.75
-7.00
-7.25
-7.50
-7.75
-8.00
-8.25
-8.50
-8.75
-9.00
-9.25
-9.50
-9.75
-10.00
N/A
-0.25
-0.50
-0.75
-1.00
-1.25
-1.50
-1.75
-2.00
-2.25
-2.50
-2.75
-3.00
-3.25
-3.50
-3.75
-4.00
1.00
1.25
1.50
1.75
2.00
2.25
2.50
2.75
3.00
N/A
N/A
Right
Left
Pair
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Instructions: