ACUVUE® KEY ACCOUNTS O1DA Units requisition form

Please fill in all fields marked with an asterix, when submitted, a copy will be emailed to you and your brand manager at Acuvue®.

KIT A

Comprising of one unit. A plinth can be added if positioned on the floor (see image below).

KIT B

Comprising of two units. Plinths can be added if positioned on the floor (see image below).

KIT C

Comprising of three units. Plinths can be added if positioned on the floor (see image below).

ADD ON UNIT

Additional smaller unit that can be used with any of the above kits.

Plinth

Plinths are used with any of the above kits if you are positioning the kits on the floor. Kit A will need one plinth, Kit B two plinths and Kit C three plinths.