Repair Mail-in Form

  • Print this form and fill it out .
  • Securely wrap your glasses and enclose this form
    along with cashiers check or money order*.
    • Be sure to include all parts (including lenses!)
    • We will repair your existing metal frames
      We cannot provide replacement parts!
  • Be sure to include your return address
    on the outside of the package.
  • We recommend you insure the shipment

4. Send to:
Eyeglass Repair
Elie Jewelry
P.O.Box 2449 • Yelm, WA 98597

Name:______________________________________________

Address:________________________________________

City:_________________St:|__|__| Zip:|__|__|__|__|__|

Phone Number: |__|__|__|-|__|__|__|-|__|__|__|__|

Email_____________________________________

Repair Titanium frames *( 1 LASER weld)
$ *39.95
each additional Titanium weld $19.95
$ 19.95
Repair Stainless Steel frames*(these are rare) (one LASER weld)|
$ *29.95
each additional weld $14.95
$ 14.95
For Priority Mail: add $5 for S&H
+$5.00
+$5.00
Or for Express Mail: add $25 for S&H|
or $25.00
or $25.00
For insurance add $2.00 per $100

Total 		$
 $

*If the frame is thin and light it is most likely made of Titanium alloy

Payment Method

|__|Cashiers Check • |__|Money order (enclosed)
- payable to Elie Jewelry -

|__|Visa • |__| Mastercard • |__|Amex • |__|Discover

Card No.: |__|__|__|__|-|__|__|__|__|-|__|__|__|__|-|__|__|__|__|

Exp.: |__|__|-|__|__| CVV code: |__|__|__|__|

I herewith authorize Elie Jewelers to charge the above total amount.

Date:__________

Signature:_______________________________________

Required for Credit card only

.

Condition of Eyeglasses

We only repair
breakage in metal frames

===========================

Please circle the points (s) of breakage

eyeglass repair, return shipping, repair, return, eyeglass,metal,eyeglasses

Our Guarantee

Our repairs are guaranteed for 1 month!

- if our repair should break within that time,
simply return it to us
- we'll either fix your frame again at no charge
to you ( just $5.00 for S & H)
or we'll refund your original fee
(excluding shipping costs).

==============================
If we are unable to repair your eyeglasses,
we'll notify you by either telephone or email. 
Your eyeglasses will be returned to you
at your expense ($5.00 S&H).
==============================

Disclaimer

Here at Laser-Fix we will safely weld
the broken metal frames
without the use of excessive heat, however
we cannot be responsible for the condition
of the lenses of your glasses (former scratches, etc.).


I understand and agree


(Sign here)_______________________

*If repairs cost exceed $30 ($40 for titanium)
you will be contacted before repair begins



Eyeglass Laser Repair
Elie Jewelry
(360) 458-5758

WWW.LASER-FIX.COM