eye
For Employers & Employees

Safety Eyewear Program

If you are part of our Safety Eyewear Program, please ensure you complete the following documents. Employees must have a signed authorization form to order safety glasses.

A woman is standing in a white room with a white wall behind her. She is wearing a black and white dress with a black belt. She is holding a white object in her hand and is looking down at it. The image has a black border on the top and bottom. The image has a watermark in the bottom right corner.

Safety Authorization

Your supervisor must sign this form, and you must bring it to your fitting. It details your specific package coverage and any lens upgrades.

Download Form
A woman is standing in a white room with a white wall behind her. She is wearing a black and white dress with a black belt. She is holding a white object in her hand and is looking down at it. The image has a black border on the top and bottom. The image has a watermark in the bottom right corner.

Safety Program Agreement

Select your participation level (Appreciation or Supported) and establish your billing preferences.

Download Form
A woman is standing in a white room with a white wall behind her. She is wearing a black and white dress with a black belt. She is holding a white object in her hand and is looking down at it. The image has a black border on the top and bottom. The image has a watermark in the bottom right corner.

On-Site Agreement Form

Required for companies requesting our Safety Program Coordinator to perform fittings directly at your facility.

Download Form