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Home » Contact Us » Appointment Request Form

Appointment Request Form

If this is an emergency, do not contact us via email, please use our emergency contact information.

To request your next appointment, please complete the form below and let us know the most convenient time and date for you. Please don’t forget to include accurate contact details so we can follow up with you to finalize your request.

  • 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.

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Reduced Staff and Office Hours

Our office will remain open for patients who are experiencing any eye-related issues, including emergency visits, non-routine exams to replace lost or broken glasses and refilling of contact lens prescriptions. We will be working reduced hours, with a skeleton staff. Please call before coming into the office, as we will not be seeing any walk-ins. We are also offering telehealth for patients experiencing any eye-related infections for those who are unable to or are not comfortable coming into the office.

We appreciate your understanding in working to keep our staff and patients safe. Please take good care of yourself and stay healthy! We will get through this!