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Contact Lens Spectrum
Issues per year: 12

Contact Lens Spectrum is the industry's most trusted source of clinical contact lens information for optometrists, opticians and ophthalmologists. Each month, Contact Lens Spectrum offers timely editorial written by contact lens practitioners for contact lens practitioners.

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Available to United States residents only
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By providing your phone and fax number you may receive only publication/customer service information via phone or fax.

QUALIFICATION FORM

Incomplete forms will not be processed. A complimentary subscription to Contact Lens Spectrum will be sent to those applicants who qualify. The publisher reserves the right to limit the number of subscriptions accepted.

1. I wish to receive Contact Lens Spectrum magazine FREE of charge.
Yes!
No

NOTE: In order to be considered for a subscription to Contact Lens Spectrum, you MUST select Yes above. If you do not select Yes, you will not receive a complimentary subscription to Contact Lens Spectrum.



2. Please check the ONE category that best describes your business/professional activity:
Dispensing Optician
Self-employed / owner
Employee of retail corporation
Employee of independent optician
Employee of independent O.D.
Employee of independent M.D.
Other dispensing optician (please specify)
Other
OPHTHALMOLOGIST
CONTACT LENS LAB / WHOLESALER
OPTOMETRIC STUDENT
OTHER (please specify)
Optometrist
Solo practice
Group practice
Corporate franchise
Independent affiliated with retail corporation
Employee of retail corporation
Employee of O.D.
Employee of M.D.
HMO
Other optometrist (please specify)
Contact Lens Technician
Employee of O.D.
Employee of M.D.
Other (please specify)

3. Do you buy, specify, approve or influence the purchase of contact lenses?
Yes
No

4. Do you fit contact lenses?
Yes
No

5. What is the average number of contact lens patients fit or refit at your office in a week?

6. On a weekly basis at your office, what is the average number of:
Quantity
RGP fits or refits
Bifocal fits or refits
Toric fits or refits

7. In order to verify your request for this publication, without the availability of a signature, our audit bureau requires that we ask a personal identifying question. This information is used solely for the purpose of auditing your request.

In what state/province were you born?

If you selected Outside of U.S. or Canada, please specify:

8. May we contact you via email?
Yes
No

9. May we contact you via fax?
Yes
No

10. May we contact you via e-mail on behalf of ophthalmic industry suppliers on topics pertinent to you?
Yes
No

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