Cutting Edge Optical
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Office Name
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Patient Name
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RT Sph
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RT Cyl
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RT Axis
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RT Prsm/Dir
RT Add
LT Sph
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LT Cyl
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LT Axis
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LT Prsm/Dir
LT Add
Seg Ht
PD's or Mono
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Lens Style
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Single Vision
FT 28
FT 35
Exec
7x28 Tri
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Round 22-24
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Material
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Plastic Uncoated
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1.56 Min Index
1.60 Hi-Index
1.67 Hi-Index
1.74 Hi-Index
Trivex
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Progessive Brand
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Adaptar
AO Compact
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Cutting Edge Value
Ellipse
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AR
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1 Year In-house AR
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Polaroid
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Polaroid Gray
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Transistions
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Trans gray
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Frame Style
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Zyl
Metal
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Tinting
A
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Edges
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Roll Only
Polish Only
Roll and Polish
B
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DBL
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ED
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Frame Name
Frame Enclosed?
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Yes.
No, on order.
Opposites OK?
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Yes
N/A
Special Instructions
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