Make an Appointment

The first step towards better vision is to schedule an appointment. Please contact our office by phone or complete the appointment request form below. We will contact you by the following business day to confirm your appointment.

Please do not use this form to cancel or change an existing appointment, or to schedule an emergency visit.

*Items in bold are required.

First Name:		Address:
Last Name:		City:
E-mail:		State/Province:
Phone:		Zip/Postal:
Preferred form of contact: Phone E-mail
Are you a current patient? Yes No
Person(s) this appointment is for: You Spouse Dependant Family
Best time(s) to call? Morning Early Afternoon Late Afternoon
Preferred day(s) of the week for an appointment? Any Day Monday Tuesday Wednesday Thursday Friday Saturday
Preferred time(s) for an appointment? Any Time Morning Early Afternoon Late Afternoon
Please describe the nature of your appointment (consultation, check-up, eye irritation, etc):
Note: Messages sent using this form are not considered private. Please contact our office by telephone if sending highly confidential or private information.

Questions regarding scheduling? Call us at 512-263-3937.

Emergency care is available by calling 512-587-7232