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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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We will be having limited hours for dispensing glasses on Monday, Tuesday, Thursday and Friday from 9AM to 2PM. You may also call 630-844-0908 to reschedule your routine eye exams during that time. Our answering service will forward any emergency (red eyes, eye pain, flashes and floaters) medical calls to our doctors.