Please read before submitting! This form is to be used by existing patients who have purchased eyeglasses with us and are wishing to use their warranty or simply a new purchase of their existing eyewear. Please complete the section below and we will reach out to you via text, email or phone call to discuss your replacement. Please note, there may be a fee associated with a new frame and/or new lenses. Thank you! Dr Jorgensen and the Vista Vision Optical Staff!