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Industrial Eyewear - Place an Order

To place an order once you've established your account with Fortney Eyecare Associates, please use the downloadable Prescription Safety Eyeware Authorization Form.
Note: This form is available in Adobe Acrobat PDF Format and requires the Adobe Acrobat Reader which can be obtained through the link below.

Download Acrobat Reader from www.adobe.com
Download Adobe Acrobat Reader

If you have questions regarding the use of this form, please contact Fortney Eyecare Associates at (313) 565-5600 between 9 a.m. and 6 p.m. and ask for Mr. Bob Taylor.

23469 Michigan Avenue, Dearborn, MI 48124   313-565-5600
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