Vision Plan Online Application



	Our Individual Vision Plans are exclusively unique to the marketplace.


	All of our Group Plans can be offered at the same time, depending on the employer or employee needs.


	Or call1-800-399-9644 for more information or quote over the phone.
	View Our Informational Videos Video Part 1 Video Part 2

Vision Care Direct Application Forms

Download (PDF) applicable form, complete and fax or mail to Vision Care Direct of Kansas.

Fax: 1-800-399-9644 (Note: ignore the voice prompt and the fax will connect)
Mailing address:
412 Main Street, Suite A
Neodesha, Kansas 66757

Employer/Group Applications

Employer Application

Individual Application

Individual Application