Appointment Request Form General Appointment Please fill in the form below to setup an appointment.Location*Downtown Vision CentreCamas Vision CentreReason for Appointment*Eye ExamContact Lens ExamMedical ExamOtherReason for AppointmentPlease provide a reason for your appointment. Details are stored securely and not sent by email.Preferred Date & TimesPlease let us know when you would prefer to have your appointment. Our hours are listed on our location page.Preferred Date* Date Format: MM slash DD slash YYYY Preferred Time*MorningAfternoonPatient Type*New patientReturning patientPlease let us know if you are a new or existing patient.Name* First Last Phone*Email* Best Time to be Reached for Confirmation : HH MM AM PM CommentsEmailThis 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:*Please SelectVision TherapyMyopia ControlScleral LensesReason for AppointmentPlease provide a reason for your appointment. Details are stored securely and not sent by email.Preferred Date* Date Format: MM slash DD slash YYYY Preferred Time*MorningAfternoonPreferred Date & TimesPlease let us know when you would prefer to have your appointment. Our hours are listed on our location page.Patient Type*New patientReturning patientPlease let us know if you are a new or existing patient.Name* First Last Phone*Email* Best Time to be Reached for Confirmation* : HH MM AM PM CommentsNameThis field is for validation purposes and should be left unchanged.
