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Inverse Independence Assistive Technology logo

Contact

Ready to explore how Independence AT can support you? Contact us today to schedule a consultation with a member of our team.

For vision services:

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Elizabeth Evans

Phone: 602-300-7014

E-mail: eevans@independencelv.com

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Yvonne Schuster

Phone: 623-570-5649

E-mail: yschuster@independencelv.com

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Breanna Poe

Phone: 480-307-3388

E-mail: bpoe@independencelv.com​​

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For hearing services: 

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Ingrid McBride

Phone: 602-578-9541

E-mail: audiologiconsultants@gmail.com

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Thank you for choosing Independence AT as your partner in independence and empowerment.

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Empowering Independence. Enhancing Lives.

Audio-Logic Consultants logo

Midwestern Referral Form

Date
Month
Day
Year
Recommendations

Ray-Ban Meta Purchase Request Form

Frame Style:

Wayfarer
Skyler

Frame Color (Based on Selected Style):

If Wayfarer:
Matte Black
Shiny Black
If Skyler:
Shiny Black

Frame Size (Based on Selected Style):

Wayfarer Size Options:
50-22
53-22
Skyler Size:
52-22

Prescription Type

Non-Prescription
Single Vision Prescription (must include current valid Rx)
Progressive Prescription (must include current valid Rx)

Upload prescription by emailing eevans@independencelv.com.

Lens Type

Single choice
Clear Lenses
Sun Lenses (non-transition)
Transitions

If selecting Sun Lenses, choose lens color:

Single choice
Blue Polarized
Dark Brown Polarized
Dark Green Polarized
Grey Dark
Green Dark
Dusty Red Polarized
Gradient Light Grey

If selecting Transitions, choose lens color:

Available for all customers:
Sapphire
Green G-15
Grey
Amethyst
Prescription-only additional options:
Brown
Amber
Emerald
Ruby

Contact Us

Independence Assistive Technology Logo

Empowering Independence. Enhancing Lives. 

Phone for Vision Services: 602-300-7014, 623-570-5649, or 480-307-3388

Toll Free Fax: 866-300-7010

Phone for Hearing Services:

602-578-9541

Thanks for submitting!

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© 2024 by Independence Low Vision.

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