Eyeglass Frame Adjustment Form
Help us understand your eyeglass frame fit and adjustment needs.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Eyeglass Frame Brand
*
Eyeglass Frame Model (if known)
How would you describe the current fit of your frames?
*
Too loose
Too tight
Slipping down nose
Uneven on face
Feels comfortable
Other
Where do you experience discomfort or issues?
*
Behind the ears
Nose pads
Frame arms
Bridge of nose
No discomfort
Other
When do you notice the fit issues most?
*
Reading
Working at a computer
Outdoor activities
Driving
All day
Other
How long have you had your current frames?
*
Please Select
Less than 6 months
6-12 months
1-2 years
More than 2 years
Not sure
What is your preferred adjustment outcome?
*
Submit
Should be Empty: