Appointments

We hope have you enjoyed our new and more informative web site. If you would like to schedule a FREE and comprehensive LASIK evaluation to determine if you are a good candidate for this life changing procedure, please complete the fields below and someone from our office will contact you soon to confirm your appointment details. Or you may call 757-345-1001 and our staff will be happy to assist you.

Please be aware that you are submitting a request only. Until you receive either an e-mail from one of our schedulers or a telephone call, you do not have an actual appointment.

In addition, please understand that you are submitting this request over the Internet. Do not include any sensitive medical information in your appointment request, for we cannot guarantee that it will not be seen by other parties.

Please do not request a "same day appointment" via this website.

Thank you.

Required information:
Title:
First Name:
Last Name:
Email Address:
Street Address:
City:
State:
Zip:
Phone (day):
Phone (evening):
Best time to call:
Optional, but helpful information:
Reason for Appointment:
I am available for an appointment on:	Please do not request a "same day appointment" via this website.
Your Optometrist:
Preferred doctor:
Preferred location:
Type of insurance:
What should the doctor know about you? This is not a secure contact form. Please do not include sensitive medical information in your appointment request that you would not normally feel comfortable sending over email.
By using this form you are submitting a request only. Until you receive either an e-mail from one of our schedulers or a telephone call, you do not have an actual appointment. Thanks for your understanding.

Appointments

Required information:

Optional, but helpful information: