REQUEST AN APPOINTMENT Contact us today to scheduleCall 866-295-2020 or fill out the form below.If this is an Emergency Referral please contact our office at 866-295-2020.First Name* Last Name* Email* Phone*Time* : Hours Minutes AM PM AM/PM Date* MM slash DD slash YYYY Appointment Type*: Cataract Exam LASIK Consultation Follow Up/Post-Op Annual Eye Exam Contact Lens and/or Glasses Exam Medical Eye Exam Other How Did You Hear About Us? TV RADIO NEWSPAPER ONLINE OTHER Select oneReferring Doctor Do you have a referring doctor, such as an optometrist, ophthalmologist, primary care doctors? (It's ok if you don't. We just want to include them in your care).Attach Patient's Any File (Optional)Max. file size: 20 MB.File type: docx, pdf, jpeg, jpg or png. Max file size: 20MB If your file is a different type please change the type or contact 866-295-2020.CAPTCHA Δ