Skip to main content
Book Exam
Call Us
Menu
Patient Portal
Patient Forms
Directions

eyeglasses-on-book
Home » Contact Us » Appointment Request Form

Appointment Request Form

  • Please fill in the form below to setup an appointment.

    Required questions are marked with a red asterisk (*) and must be completed before submitting the form.

  • 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.
  • Date Format: MM slash DD slash YYYY
  • Date Format: MM slash DD slash YYYY
  • This field is for validation purposes and should be left unchanged.

Join Our Email List to Receive Exclusive Offers!

  • This field is for validation purposes and should be left unchanged.

x

COVID Virus Update

Starting the week of March 30th, we will be open Monday to Friday, 10 AM to 2 PM.

We will have a team member available to take your calls to place eyewear and contact lens orders, handle shipping requests, and answer any questions about eye emergencies and eye health. All orders taken over the phone will be shipped to your address on file with Free Shipping. In case of emergencies, please still call us at (319) 373-3737 and will have one of our doctors assess your needs. We are monitoring the situation closely and taking it day-by-day. We are confident that we will get through this and together we will be stronger.