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Appointment Request Form

Due to the increase of patients cancelling on short notice, we have been forced to enact a $75 no show fee. To avoid the fee in the event of a cancellation, please contact us at least 48 hours before your scheduled appointment. We thank you for your understanding!

General Appointment

  • Please fill in the form below to setup an appointment.
  • Please provide a reason for your appointment. Details are stored securely and not sent by email.
  • Please let us know when you would prefer to have your appointment. Our hours are listed on our location page.
    Please let us know if you are a new or existing patient.
  • :
  • This field is for validation purposes and should be left unchanged.

Specialty Appointment - Vision Therapy | Myopia | Scleral Lenses | Dry Eye

  • Please fill in the form below to setup an appointment.
  • Please provide a reason for your appointment. Details are stored securely and not sent by email.
  • MM slash DD slash YYYY
  • Hidden
    Please let us know when you would prefer to have your appointment. Our hours are listed on our location page.
    Please let us know if you are a new or existing patient.
  • Hidden
    :
  • This field is for validation purposes and should be left unchanged.