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Appointment Request Form

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

To request your next appointment, please complete the form below and let us know the most convenient time and date for you.  Please don't forget to include accurate contact details so we can follow up with you to finalize your request.

  • 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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Pay your bill with Care Credit

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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. If you have an eye emergency after hours, call 570-242-0632 or contact your nearest urgent care or emergency care facility

Thank you for your patience and understanding!