Appointment Request Form Please fill in the form below to setup an appointment.Reason for AppointmentPlease provide a reason for your appointment. Details are stored securely and not sent by email.Patient Type(Required) New patient Returning patientPlease let us know if you are a new or existing patient.Name(Required) First Last Phone(Required)Email(Required) EmailThis field is for validation purposes and should be left unchanged. Call Us 24x7 250-724-0933 Write Us info@valleyvisionoptometry.ca Main Office 4009 Redford St Port Alberni, BC V9Y 3R9