Make An Appointment

We would appreciate it if you would take a few moments to answer the following questions. Please be assured that we do not share or sell personal information about you except when we have your permission.

First Name

M.I.

Last Name

Address Line 1

Address Line 2

City

State

Zip Code

Country

E-mail Address

Phone

Cell

Bold = Required field

Are you a New Patient?

Yes

Date of Birth

How to Reach You

Telephone

E-Mail

Appointment Preference

Monday

Tuesday

Thursday

Friday

I wear contacts/or want to be fit for contact lenses

Vision Insurance or Health Insurance Normally Used

Message or Reason for Appointment

Make Appointment:

Office Hours Daily Monday - Friday 8:00 am - 5:00 pm and Thurdays until 6:00 pm

We now offer an appointment scheduling service online for your convenience. You will be able to request mornings, afternoons, and the day of the week preferred.

If there are certain times of the day that would be best for you, please indicate that in the Message box. If you have broken glasses, lost contact lenses, or have a medical eye emergency, you should call us directly so we can make the most immediate opening available to you. Our office hours are listed on the Locate Us page of our Web site. You may e-mail us 7 days a week, 24 hours a day, and we will respond as soon as possible when the office is open. Fill out the appropriate information below for an Eye examination or Contact Lens fitting appointment. Appointments are not needed to fill eyeglass prescriptions. Simply come in during office hours.

Save time on your first visit and fill out the Patient Info Form at home.