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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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In order to keep our patients safe and prevent the spread of COVID-19, our office is adhering to strict CDC/SCC guidelines, including: (1) Face Mask Requirement for all, (2) Temperature Checks upon entering, (3) Hand sanitizer/washing upon entering, (4) Social Distancing, (5) HEPA13-grade Air Purifiers every 200 sq ft, (6) Advanced UV Sanitization of frames, (7) Sterilization of commonly touched surfaces/equipment, (8) Hand sanitizer/washing stations every 50 sq ft, (9) Building Capacity limitation. (10) All staff and doctors have been vaccinated