Please fill in the form below to setup an appointment.

Location*

If you are booking an eye exam OR medical appointment for our Bridgeland location, please click here to continue to our online scheduler.

If you are looking for a more complex visit, such as vision therapy or myopia management consultation, please continue to fill out the form below or simply call us.

Reason for Appointment

Please provide a reason for your appointment. Details are stored securely and not sent by email.

Do you wear contact lenses?*

Yes
No

Preferred Date & Times

Please let us know when you would prefer to have your appointment. Our hours are listed on our location page.

Patient Type*

New patient
Returning patient

Please let us know if you are a new or existing patient.

Name*

First Last

Date of Birth*

Phone*

Address*

Street Address Address Line 2 City Province Postal Code

Email*

Comments

Today's Date

Phone

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Appointment Request Form

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