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Low Vision Vision Therapy

Call 844-505-4250
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
.

Complete the following form:

  • 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 if you are a new or existing patient.
  • This field is for validation purposes and should be left unchanged.
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Updated Hours Due to Covid-19

Our office is temporarily closed, please schedule a telemedicine appointment for emergency medical eyecare and prescription renewals.

Telemedicine Hours: Monday – Friday 8am-12pm and 1pm-4pm. To schedule an appointment, call our office at (250)724-0933.