Schedule an Appointment

To request an appointment, fill out the form below and click submit. We will email you with three possible appointment times, you pick the one you prefer, and we'll take care of the rest!
Note: This form should not be used for emergencies. If you have an after hours eye emergency, please call 336-760-2020 and choose option 4

*(denotes required field)

First Name: *

Last Name: *

E-Mail Address: *

Street Address

City, State, Zip

Phone Number *

Please check which services you will be needing (check all that apply): *

Comprehensive Eye Exam Contact Lens Evaluation Medical Office Visit

Preferred Day for Exam: *

Monday Tuesday Wednesday Thursday Friday

Preferred Time for Exam: *