ASANA™ GP Order form

Bausch + Lomb Account No:

Email:

example@example.com

Your name:

First NameLast Name

Address:

Phone Number:

Please include country code (e.g. +44)

Country:

Patient / Order Reference:

Purchase Order No:

Type of order:

Initial lens patient / order reference:

Initial lens order date:

Warranty Calc

For any support with your order, please connect with our expert consultants:

Visit Bausch + Lomb Specialty - Contact Us Page

Seamlessly transition your GP lens orders to Asana™.

Click below to view the Asana™ Parameters and Transition Guide.

VIEW THE PARAMETERS

PARAMETER ANZEIGEN

180 DAY
UNLIMITED LENS REMAKES
THROUGH THE
EZ-EXCHANGE
WARRANTY PROGRAM

Asana™ design (Right OD)

Select lens design or "None" for No Right Lens (OD)

R FP Code Calc

R PS Code Calc

R PS Code

R FP Code

Material (Right OD)

RMAT Calc

R Mat Code Calc

RB hide drop

RB Val

Whole number

Decimal (0.01)

Whole number

Decimal (0.01)

Whole number

Decimal (0.01)

Whole number

Decimal (0.01)

RB Calc

ERROR (RB): Please check the Right Lens (OD) Base Curve BOZR is within range.

You have entered a value that exceeds the specification range.

Whole number

Decimal (0.01)

Whole number

Decimal (0.01)

ERROR (RST): Please check the Right Lens (OD) Steep Radius is within range.

You have entered a value that exceeds the specification range.

RST Calc

Whole number

Decimal (0.1)

Whole number

Decimal (0.1)

Whole number

Decimal (0.1)

RD Calc

ERROR (RD): Please check the Right Lens (OD) Diameter is within range.

You have entered a value that exceeds the specification range.

Whole number

Decimal (0.12D)

ERROR (RP): Please check the Right Lens (OD) Power is within range.

You have entered a value that exceeds the specification range.

RP Calc

Whole number

Decimal (0.12D)

ERROR (RRP): Please check the Right Lens (OD) R-Power is within range.

You have entered a value that exceeds the specification range.

RRP Calc

CYL -0.25 to -5.00 (0.25)

RCYL Calc

AXIS 1 to 180° (1°) steps

RAXIS Calc

ADD Up to 3.50 (0.25) steps

RADD Calc

Right (OD) Notes:

Asana™ design (Left OS)

Select lens design or "None" for No Left Lens (OS)

L FP Code Calc

L PS Code Calc

L PS Code

L FP Code

Material (Left OD)

LMAT Calc

L Mat Code Calc

LB hide drop

LB Val

Whole number

Decimal (0.01)

Whole number

Decimal (0.01)

Whole number

Decimal (0.01)

Whole number

Decimal (0.01)

LB Calc

ERROR (LB): Please check the Left Lens (OS) Base Curve BOZR is within range.

You have entered a value that exceeds the specification range.

Whole number

Decimal (0.01)

Whole number

Decimal (0.01)

LST Calc

ERROR (LST): Please check the Left Lens (OS) Steep Radius is within range.

You have entered a value that exceeds the specification range.

Whole number

Decimal (0.1)

Whole number

Decimal (0.1)

Whole number

Decimal (0.1)

LD Calc

ERROR (LD): Please check the Left Lens (OS) Diameter is within range.

You have entered a value that exceeds the specification range.

Whole number

Decimal (0.12D)

ERROR [LP]: Please check the Left Lens (OS) Power is within range.

You have entered a value that exceeds the specification range.

LP Calc

Whole number

Decimal (0.12D)

ERROR (LRP): Please check the Left Lens (OS) R-Power is within range.

You have entered a value that exceeds the specification range.

LRP Calc

CYL -0.25 to -5.00 (0.25)

LCYL Calc

AXIS 1 to 180° (1°) steps

LAXIS Calc

ADD Up to 3.50 (0.25) steps

LADD Calc

Left (OS) Notes:

ERROR: There appears to be an error in one or more of your lens specifications.

Please check the form to ensure that all specifications are within range.

ERROR: You must configure at least one lens to continue.

Customer Details	Submitted Information
Name:	{yourName}
Email:	{email}
Phone:	{phoneNumber}
Country:	{country}
B+L Account:	{BLaccountNo}
Address:	{address}
Order Ref:	{refNo}
PO Number:	{PO_no}
Type of order:	{typeOf}

Warranty Details	Submitted Information
Initial order ref:	{initialLens}
Initial order date:	{initialDate}

	Right Lens (OD)	Left Lens (OS)
Design:	{rDesign}	{lDesign}
Material:	{rmatCalc}	{lmatCalc}
Base Curve (Flat):	{rbCalc}	{lbCalc}
Base Curve (Steep):	{rstCalc}	{lstCalc}
Diameter:	{rdCalc}	{ldCalc}
Power (Flat):	{rpCalc}	{lpCalc}
Power (Steep):	{rrpCalc}	{lrpCalc}
Cyl:	{rcylCalc}	{lcylCalc}
Axis:	{raxisCalc}	{laxisCalc}
ADD:	{raddCalc}	{laddCalc}

Order Notes	Details
Right Lens (OD):	{rightod}
Left Lens (OS):	{leftos}

Kundendaten	Übermittelte Informationen
Name:	{yourName}
E-Mail:	{email}
Telefon:	{phoneNumber}
Land:	{country}
B+L Kundennummer:	{BLaccountNo}
Bestellreferenz:	{refNo}
Bestellnummer:	{PO_no}
Bestellart:	{typeOf}

Garantiedetails	Übermittelte Informationen
Ursprüngliche Bestellreferenz:	{initialLens}
Ursprüngliches Bestelldatum:	{initialDate}

	Rechtes Auge (OD)	Linkes Auge (OS)
Design:	{rDesign}	{lDesign}
Material:	{rmatCalc}	{lmatCalc}
Basiskurve (BOZR) FLACH:	{rbCalc}	{lbCalc}
Basiskurve (BOZR) STEIL:	{rstCalc}	{lstCalc}
Durchmesser:	{rdCalc}	{ldCalc}
Stärke (FLACH):	{rpCalc}	{lpCalc}
Stärke (STEIL):	{rrpCalc}	{lrpCalc}
CYL:	{rcylCalc}	{lcylCalc}
Achse:	{raxisCalc}	{laxisCalc}
ADD:	{raddCalc}	{laddCalc}

Bestellnotizen	Details
Rechtes Auge (OD):	{rightod}
Linkes Auge (OS):	{leftos}

Review and Confirm

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Asana™ GP Order Form

German

RIGHT LENS (OD)

Base Curve (BOZR) FLAT 5.00 to 10.00 mm (0.01 steps)

Base Curve (BOZR) FLAT 6.00 to 9.00 mm (0.01 steps)

Base Curve (BOZR) FLAT 6.00 to 11.00 mm (0.01 steps)

Base Curve (BOZR) FLAT 4.50 to 8.00 mm (0.01 steps)

Base Curve (BOZR) STEEP 5.00 to 10.00 mm (0.01 steps)

Base Curve (BOZR) STEEP 6.00 to 9.00 mm (0.01 steps)

Diameter 7.0 to 12.5 mm (0.1 mm steps)

Diameter 8.0 to 12.0 mm (0.1 mm steps)

Diameter 8.0 to 10.6 mm (0.1 mm steps)

Power FLAT +30D to -30D (0.12D steps)

Power STEEP +30D to -30D (0.12D steps)

Astigmatism / Near

LEFT LENS (OS)

Base Curve (BOZR) FLAT 5.00 to 10.00 mm (0.01 steps)

Base Curve (BOZR) FLAT 6.00 to 9.00 mm (0.01 steps)

Base Curve (BOZR) FLAT 6.00 to 11.00 mm (0.01 steps)

Base Curve (BOZR) FLAT 4.50 to 8.00 mm (0.01 steps)

Base Curve (BOZR) STEEP 5.00 to 10.00 mm (0.01 steps)

Base Curve (BOZR) STEEP 6.00 to 9.00 mm (0.01 steps)

Diameter 7.0 to 12.5 mm (0.1 mm steps)

Diameter 8.0 to 12.0 mm (0.1 mm steps)

Diameter 8.0 to 10.6 mm (0.1 mm steps)

Power FLAT +30D to -30D (0.12D steps)

Power STEEP +30D to -30D (0.12D steps)

Astigmatism / Near

Check Lens Specifications

German