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1-800-233-9637

Open New Optical Account

To become a Luzerne Optical customer, please complete the following information. You will be notified when your account has been set up---in approximately 5 business days.

The fields marked with * are mandatory

Ship To:

 
 
 
 
 
 
 
 
 
 
 
 
*
*

How did you hear about Luzerne Optical?:

 
 
 
 
 
 

Courier Services you are currently using?:

(Check all that apply.)
 
 
 
 

Bill To:

 
 
 
 
 
 
 
 
 
 
*

Credit Application:

To obtain a Luzerne Optical Credit Application, go to the top of the page and click on the "Login / New Account" tab, and then click “Credit Application"; or, you can Copy & Paste the link below into your browser and hit Enter.
Credit Application link: www.LuzerneOptical.com/pdf/luzerne-optical-labs-credit-application.pdf
If you are billing through a Buying Group that Luzerne Optical is a vendor for, there is no need to fill out the Credit Application.
If you are billing direct through Luzerne Optical please fill out the Credit Application.
Submission Instructions:
Please fill out the Credit Application ONLINE, then print out, sign and return via mail, email or fax to our office. We prefer the application to be filled out online (in text) rather than by hand. This will eliminate errors.
The application can be faxed to 1-800-525-5597 or 570-823-4299.
Or mail to: P.O. Box 998 Wilkes-Barre, PA 18703-0998, or 180 N. Wilkes-Barre Boulevard Wilkes-Barre PA 18702-5341.
It can also be sent via email to vision@luzerneoptical.com. Thank you.

Type of Work to be Ordered from Luzerne Optical?:

(Check all that apply.)
 
 
 
 
 
 
 
 
 
 
 

Attention Mail Room, Please Send Me:

 
 
 
 
 
 
 
 
 
 
 
 
 

Additional Information:

 
 
 


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