Clip House - Order Form

2 easy ways to order

Option A) Send in a frame:
Send in the order with your patient’s frame, then Clip House will custom match the shape and the match the color of the frame.

Option B) WITHOUT send in a frame:
Please check online or call us for our frame database, which we have over 45,000 frame files on our library. If we have the frame on file, then you don’t have to send us your patient’s frames. Just fill out the order form and FAX it over to us. (Need a color sample if want “color match”)

Frame Search
Please Read before Ordering
Shipping Charge

Order Form
(Please read carefully before filling out form)

Date (mm/dd/yy) :

Company Name :

Address :

Phone :

Fax :

(Please read carefully before filling out form)

Patient Name :

Rush Order* $10 Extra (2 business day)

1. Frame Information

Brand Name :

Model # :

Frame Color:

Eye Size

Top Bar Option Standard Long Bar Exclusive Hidden bridge
****Frame need to be sent in****

Prong Size Option S=under 5mm M=between 5 to 9mm L=above 9mm

3 Piece Drill Mounts
Must have a separate pattern in exact shape & size needed
If sent without pattern is $10 extra charge

2. Match Clip-On Color (FREE)
Match (85%+)

Temple Bridge (front) Bridge (top) Rim wire (front) Rim wire (top)

Color :

Finish:

Shiny Matte Antique Shiny Antique Matte

We do not do tortoise and neon colors. Therefore, please choose a different color and select the finish.

For all orders Clip House does not keep color samples.
For color match please send color sample

3. Standard Clip On Color

Color: Black Silver Gold Gunmetal Brown Other
If other please give color

Finish: Shiny Matte Antique Shiny Antique Matte
* Standard color for jobs without color sample

4. Available Lens Colors
PC UV400 with Back AR Coating

G15	Smoke gray	Brown
Blue Gray	Orange	True blue

* Color sample may be different *
** Change lens ** Only colors available, we do not tint. No AR or mirror coating.

PC polarize (Back Side A/R polarize Available in Grey and Brown)
Polarized brown Polarized gray Polarized G-15

CR-39 polarize
Polarized brown Polarized gray Polarized G-15

5. Shipping

UPS (2 days service if nothing is selected. CA customers will be sent ground)

Next Day - Morning before 10:30am - $23.50*
Next Day - Afternoon before 3:00 pm - $21.50*
2nd Day - $9.75*
3rd Day - $8.50*
Ground - $6.00*
COD - add $9.00*

* Shipping price based on 1 lb. weight and dimension of box
** If nothing is selected: Automatic "2nd day" service. California customers will be sent "Ground".

Clip House is not responsible for packages that are not insured. UPS only covers up to
$100 if not insured. No exceptions. For re-dos caused by Clip House, job will be sent back by
UPS 2nd day.

6. Payment
Credit Card Check to be mailed Bill Account COD Bill C&E
* For billing questions, please call accounts receivable (888) 393-8118

7. Comments and Special Instructions:

All re-dos must be sent back with a copy of the original invoice. Changes from
original order will result in charges. Regular jobs ship out on the 6th business day.

Where to send your frame?
Clip House
1988 West Holt Ave.
Pomona, CA 91768
Tel: (888) 393-8118
Tel: (909) 236-5136
Fax: (909) 236-5142
E-mail: service@cliphouseinc.com
vicki.sales@cliphouseinc.com

Processing Time
The average time to process your order is 3-4 business days in addition to shipping time.

<< Back