Bailey Lovie Visual Acuity Charts for Distance (2 Charts)
180.00
BLD2
Bailey Lovie Visual Acuity Charts for Distance - Clear (2)
160.00
BLN1
Bailey Lovie Visual Acuity Charts for Near (2 Charts)
35.00
BLW1
Bailey Lovie Reading Charts for Near (5 Charts)
50.00
BHC1
Bailey Lovie Cereal Test
45.00
D-15
D-15 Color Kit
85.00
NPC2
New and Improved Near Point Card
25.00
NPC1
Near Point Cards (2 card set)
15.00
6810
Contact Lens Forms / Series 6810 (per 100)
50.00
6810E
Extended Contact Lens Forms / Series 6810 (per 100)
50.00
E200
Envelopes, RX (per 100)
80.00
6/71
Refraction Forms, RX (per 100)
50.00
6396
Refraction Forms, RX (per 100)
40.00
UC Optometry Alumni Polo Shirts ARE available! Please EMAIL for more information.
Discount, if applicable:
Annual Renewal Members receive a 15% discount;
Life Members receive a 25% discount
Subtotal
Sales Tax: CA residents only, add 8.25%
Shipping & Handling (leave blank — will be added by UCOAA)
Total
Date of Purchase:
Optometrist's Name:
Optometrist's Phone:
Tel:
Fax:
Optometrist's Email:
Ordered by:
Billing/Mailing Address:
City / State / ZIP Code:
Send no payment when ordering.
Shipping charges will be added and an invoice for the
total amount will be sent.
• Fax your order to 510-643-0459.
• Please call if you have questions (510-642-4491).
Payment should be made by Check (US Dollars only) to the Optometry Alumni Association. No credit card payments will be accepted.
Electronic Routing Information: Please call for information (510-642-4491).
UC Optometry Alumni Polo Shirts ARE available! Please 