Skip to main content
Call (408) 883-3236
Request an Appointment
sunglasses-row-white-bg
Home » Contact Us » Appointment Request Form

Appointment Request Form

If this is an emergency, do not contact us via email, please use our emergency contact information.

Complete the following 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.
  • :
  • This field is for validation purposes and should be left unchanged.

Our Open Hours

  • 9:00 AM - 5:30 PM
  • 10:30 AM - 7:00 PM
  • 9:00 AM - 5:30 PM
  • 9:00 AM - 5:30 PM
  • 8:00 AM - 2:00 PM
  • 8:00 AM - 2:00 PM
  • Closed

Friday and Saturday: Early appts available on request

Open Hours:

  • 9:00 AM - 5:30 PM
  • 10:30 AM - 7:00 PM
  • 9:00 AM - 5:30 PM
  • 9:00 AM - 5:30 PM
  • 8:00 AM - 2:00 PM
  • 8:00 AM - 2:00 PM
  • Closed

Friday and Saturday: Early appts available on request

Schedule Appointment - Online Form