Appointment Scheduler

Please select a location.

To book an appointment,
please select a provider.

Please select a date and time

All fields are required

Please enter your personal information

All fields are required

Male Female

Are you an existing patient?

Additional Notes

All fields are required

If you desire a contact lens evaluation, would this be your first time trying contacts?

What is the main reason for this visit?

Please Enter your Insurance Information

BlueCrossBlueShield, United Healthcare, Priority Health, Aetna, etc

Enter your medical insurance plan

Enter your vision insurance if any

Who is the primary insured party?

Review and Submit

Please review then click submit.

Exams booked as self-pay will NOT be processed for insurance unless insurance is provided 24 hours BEFORE the booked appointment. Please provide proper insurance information

1. Personal Details
- First Name:
- Last Name:
- Dob:
- Email:
- Phone:
2. Appointment details
- Reason for visit:
- Appointment time:
- Location:
- Provider:

Please select a location.

What is the reason for this visit?

To book an appointment, please select a provider.

Please select a date and time

Please enter your personal information

Additional Notes

Please Enter your Insurance Information

Review and Submit

1. Personal Details

2. Appointment details

To book an appointment,
please select a provider.