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Thank you for purchasing EYEGLASS RESCUE. To register with the EYEGLASS RESCUE Retrieval Center, please complete all the information requested below:

Personal Information

First Name Initial 
Last Name
Street Address
City/Town State  Zip 


ID Number (enter your ID Number exactly as it appears on your ID Sleeve)

ID Number


Referral (please tell us how you heard about EYEGLASS RESCUE)



Where Purchased (please tell us where you purchased your EYEGLASS RESCUE Kit)

Where Purchased


When an individual finds your glasses and contacts EYEGLASS RESCUE, we will provide the finder with your name (address or telephone number will not be provided), and we will immediately contact you to provide you with the name, address and telephone number of the finder. This is the quickest way to retrieve your lost glasses in the event that the finder is someone you know. If requested, your glasses can be recovered by EYEGLASS RESCUE’s Retrieval Service, which will forward the glasses to you for an additional fee.


Contact Information

Telephone Number - -
Cell Phone Number - -


Note, To make changes in your registration information, please send email to service@eyeglassrescue.com , or call us at 1.888.950.7507