Academy for Eye Care Excellence™

Request myalcon.com Vision Care
Online Ordering ID

*Required


*Courtesy Title
Dr.
Mr.
Mrs.
Miss
Ms.

*First Name

*Last Name

Company/practice name

*Email Address

*Phone Number

*Alcon Vision Care (Formerly CIBA VISION) Account Number [?]You must have an Alcon Vision Care (formerly CIBA VISION) account to enroll for online ordering. If you don't have an account, sign up by calling our credit department.

US Credit Forms: 800-241-5999
Canadian Credit Forms: 800-268-3968

*Postal / Zip Code

*Country (U.S. or Canada)?

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Sign Up for a Vision Care Account

You must have an Alcon Vision Care (formerly CIBA VISION) account to enroll for online ordering. If you don't have an account, sign up by calling our credit department.

Alcon U.S. Credit Department
US Credit Forms: 800-241-5999
Fax: 800-757-4954
customer.profile@alcon.com

Alcon Canada Credit Department
Canadian Credit Forms: 800-268-3968
Fax: 866-231-2422
canada.credit@cibavision.com

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