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Appointment Request 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 when you would prefer to have your appointment. Our hours are listed on our location page.
    Please let us know if you are a new or existing patient.
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  • This field is for validation purposes and should be left unchanged.
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Due to the CDC recommendation, we are seeing patients solely for emergency purposes.

Please call us to triage you eye issues and we will do all we can to assist you.

If you have no other means of vision for your work, please know that we are considering this an emergency and you can be seen. We would especially like our healthcare workers to know that we are here to serve you so please call us if you need us.

If you have glasses or contact lenses to pick up, you need to schedule a time so please call. We are still available if you need any orders to be made and we can directly ship contact lenses to you.

Thank you and be well,

Dr. My Dinh