Name (required)

Phone (required)

Your Email (required)

Are you a new patient or existing?New PatientExisting Patient

What is the name of your vision insurance? (type 'none' if you do not have it)

Preferred day of the week?MondayTuesdayWednesdayThursdayFridaySaturdayNo Preference on Day

Preferred time? MorningAfternoonNo Preference on Time

Service Requested (required)—Please choose an option—Contact Lens FittingEye ExamEye Glasses FittingEye InfectionMedical Eye Visit

Comments (please leave additional questions or comments related to your appointment.

Enter the code:

Please note that the date and time you requested may not be available. We will contact you during normal business hours to confirm your actual appointment details. Please call 817-514-0100 and speak to our staff for same day appointments. Thank you.

Δ