Schedule an Appointment

If you would like to look at eyewear or if you are in need of an adjustment/ repair, please call us at:

952-260-8282

We are able to text you appointment information. If texting is preferred communication for you, tell us at your appointment.

Name

First Name

Last Name

Date of Birth

YYYY

Address

Email Address

Phone

(###)

###

####

Will you be using Insurance for this visit? If yes, What is your insurance carrier?

Subject

Message

What Date and Time would be ideal for an appointment?

APPOINTMENT DATE: FIRST CHOICE

YYYY

APPOINTMENT TIME: FIRST CHOICE

Hour

Minute

Second

APPOINTMENT DATE: SECOND CHOICE

YYYY

APPOINTMENT TIME: SECOND CHOICE

Hour

Minute

Second

What kind of appointment do you need?

Comprehensive Eye Exam

Comprehensive Eye Exam with Contact Lens Evaluation

Optical Shoppe Appointment - choosing eyewear

Other

Would you like to receive text messages about your appointment?

If yes, what is your cell phone number (if different than above)?

Do you have any concerns you'd like to discuss during your appointment?