Appointment Request Form

Name: DOWNTOWN VISION CENTRE
Address: 912 Main St, Vancouver, WA, 98660, US
Telephone: 360-694-6541
Price range: $000 - $300

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.
Location
Reason for Appointment
Please provide a reason for your appointment. Details are stored securely and not sent by email.
Preferred Date & Times*
Please let us know when you would prefer to have your appointment. Our hours are listed on our location page.
Patient Type*
- New patient
- Returning patient
Please let us know if you are a new or existing patient.
Name*
First Last
Phone*
Email*
Best Time to be Reached for Confirmation*

: Hours

Minutes
Comments
Phone
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.
Type of Specialty:*
Reason for Appointment
Please provide a reason for your appointment. Details are stored securely and not sent by email.
Preferred Date*
MM slash DD slash YYYY
Preferred Time*
Hidden
Preferred Date & Times
Please let us know when you would prefer to have your appointment. Our hours are listed on our location page.
Patient Type*
- New patient
- Returning patient
Please let us know if you are a new or existing patient.
Name*
First Last
Phone*
Email*
Hidden
Best Time to be Reached for Confirmation*

: Hours

Minutes
Comments
Comments
This field is for validation purposes and should be left unchanged.

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