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Appointment Request

The first step towards better vision is to schedule your appointment.

Schedule a LASIK Consultation 

Click the button above to schedule a LASIK consultation.

To schedule any other appointments please complete the appointment request form below or contact our office by phone at 239-431-7070

Please do not use this form to cancel or change an existing appointment.

*Items in bold are required.


Preferred day(s) of the week for an appointment?

Preferred time(s) for an appointment?

Please describe the nature of your appointment (e.g., consultation, check-up, etc.):

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Note: Messages sent using this form are not considered private. Please contact our office by telephone if sending highly confidential or private information.