Contact Lens Auto-Renewal Form

Simplify Vision Care with Contact Lens Auto-Renewal Forms

Managing contact lens subscriptions shouldn't feel like a chore. Whether you're an optometry practice, online optical retailer, or vision care provider, a contact lens auto-renewal form helps your customers stay stocked with the lenses they need—without the hassle of remembering to reorder every few months.

With Paperform's contact lens subscription form template, you can collect prescriptions, manage brand preferences, coordinate insurance benefits, and set up automatic recurring orders—all in one seamless, patient-friendly experience.

Why Contact Lens Subscription Forms Matter

For optical retailers and eye care practices, subscription models create predictable revenue and improve patient compliance. Customers get the convenience of automatic deliveries, while you build long-term relationships and reduce the friction of repeat purchases.

A well-designed auto-renewal form captures everything you need upfront: current prescription details, lens brand and type, wearing schedule, delivery preferences, and insurance information. This means fewer back-and-forth emails, reduced cart abandonment, and happier customers who never run out of lenses.

What Makes Paperform Perfect for Vision Care Subscriptions

Paperform is built for healthcare providers, e-commerce brands, and service businesses that need professional forms with payments, file uploads, and smart automation—without writing code.

Prescription management made easy: Use file upload fields to collect prescription images or PDFs directly in the form. Customers can snap a photo of their prescription card or upload a document from their optometrist, keeping everything organized in one place.

Flexible subscription options: Whether you're offering monthly, quarterly, or annual deliveries, Paperform's subscription fields integrate with Stripe to handle recurring billing automatically. Set up different plans for daily disposables versus monthly lenses, and let customers choose the schedule that fits their lifestyle.

Insurance coordination: Collect insurance provider details, policy numbers, and authorization information right in the form. Use conditional logic to show insurance fields only when needed, streamlining the experience for both insured and out-of-pocket customers.

Brand and product preferences: Use dropdown menus or choice fields to capture lens brand, type (daily, bi-weekly, monthly), power specifications, and special features like toric lenses for astigmatism or multifocal options. The more detail you collect upfront, the fewer customer service inquiries you'll handle later.

Backup pair options: Offer customers the option to add backup glasses, solution bundles, or extra boxes at a discount—all calculated automatically using Paperform's built-in pricing engine.

Automate Your Workflow with Stepper

Once a customer submits their auto-renewal form, Stepper (stepper.io) can take over the behind-the-scenes work. Automatically verify prescription details with your inventory system, send welcome emails with delivery schedules, create customer records in your CRM or optical management software, and set reminders for prescription renewal dates.

You can route submissions to different fulfillment teams based on lens type, trigger insurance verification workflows, or flag prescriptions that are about to expire—all without manual data entry.

eSignatures for Prescription Consent

For compliance and record-keeping, use Papersign (papersign.com) to send prescription authorization forms, HIPAA consent, or vision insurance assignment of benefits documents for secure eSignature. Keep the entire subscription enrollment process digital, compliant, and traceable.

Who This Template Is For

This contact lens auto-renewal form is ideal for:

• Optometry and ophthalmology practices offering direct-to-patient lens subscriptions
• Online optical retailers and e-commerce stores selling contact lenses with recurring delivery
• Vision care chains and franchises looking to increase subscription revenue
• Optical labs and wholesalers managing B2B lens subscriptions for practices
• Health and wellness brands bundling vision care products with subscription services

Built for Conversion and Compliance

Paperform forms don't look like generic surveys—they look like part of your brand. Customize fonts, colors, button styles, and backgrounds to match your practice or retail site. Embed the form directly on your website, or use it as a standalone landing page with your custom domain.

With SOC 2 Type II compliance, data residency controls, and GDPR-friendly features, Paperform gives you the security and trust your customers expect when sharing sensitive health information.

Get Started with Contact Lens Subscriptions

Stop losing customers to the hassle of manual reordering. Set up a professional contact lens auto-renewal form with Paperform, connect your payment processor, and start building predictable subscription revenue while delivering a better patient experience.

Whether you're launching a new subscription program or upgrading from clunky paper forms and phone orders, Paperform makes it easy to create a vision care experience that's as clear as your customers' sight.