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Order a replacement of lenses on-line

You may use this form to ask for your reservation of lenses to be picked up at any one of our shops.

Main data

If you already have a customer file, you must enter the telephone number which you gave us.

Characteristics for the lenses

If you do not have full details which we are asking you for on this form, you are advised to go to one of our shops and have a revision so your record is available for future requests.

Left Eye Right Eye
Grading of contact lenses
Type of lens
Pick-up shop


Before sending the form you should read the following basic information about data protection: The person responsible for the treatment is Óptica Balear S.A. Your data will be processed for the processing of your request and compliance with our legal obligations. The legitimation of the treatment is the management of the relationship with our users and legal obligations. No data will be transferred to third parties except legal obligation. You have the right to access, rectify and delete the data, as well as other rights as explained in the additional and detailed information on Data Protection accessible in the Privacy Policy published on this Website.