Request an Appointment Open by appointment only. Please enable JavaScript in your browser to complete this form.Name *FirstLastPhone number *Email *BirthdayWe need your birthday to open your file if you choose to take an appointment. All information is confidential. What can we do for you?Routine eye exam Emergency eye examPediatric eye exam (age 5 and up; Thursdays from 2pm to 6pm)Contact lens adjustmentDiabetic eye examGlaucoma screeningFrame choiceGlasses adjustment (for glasses purchased at our clinic)Please check all that applyDate / Time Option 1 DateTimeDate / Time Option 2DateTimeDate / Time Option 3 DateTimeHow did you hear about our clinic?InternetFamily/friendReferral from doctorAlready a patient here OtherComment or MessageSign-up to our newsletter?PhoneSubmit
