Please fill out the form below and we will contact you via phone to schedule your appointment. This is only a request, filling out this form does not guarantee availability. For your security, please do not submit any protected health information such as your SSN, DOB or Insurance card details. Request an Eye Exam Which office location would you like? ---KALAMAZOO / DOWNTOWNKALAMAZOO / DRAKE ROADKALAMAZOO / EAST SIDEKALAMAZOO / WESTMAINKALAMAZOO / WESTNEDGE HILLKALAMAZOO / OAKWOODKALAMAZOO / PORTAGEGRAND RAPIDS / BRETON VILLAGEGRAND RAPIDS / CASCADEGRAND RAPIDS / GRAND RAPIDS 28TH ST SEGRAND RAPIDS / GRANDVILLEGRAND RAPIDS / JENISONGRAND RAPIDS / KENTWOOD 44TH STGRAND RAPIDS / KENTWOOD SOUTHGRAND RAPIDS / KNAPP'S CROSSINGGRAND RAPIDS / PLAINFIELDGRAND RAPIDS / PLAINFIELD NORTHGRAND RAPIDS / ROCKFORDGRAND RAPIDS / WALKERGRAND RAPIDS / WALKER / STANDALEGRAND RAPIDS / WYOMING 28TH ST SWDETROIT / ALLEN PARKDETROIT / ANN ARBORDETROIT / LIVONIADETROIT / FARMINGTON HILLSDETROIT / PLYMOUTHDETROIT / SOUTHGATEDETROIT / WOODHAVENBATTLE CREEKBENTON HARBORCHARLOTTECOLDWATERGRAND HAVENHASTINGSHOLLAND / CENTRALHOLLAND / NORTHHOLLAND / SOUTHIONIAJACKSONJACKSON WESTJONESVILLE / HILLSDALELANSINGMUSKEGONMUSKEGON / FRUITPORTNILESNORTON SHORESOKEMOSOTSEGO / PLAINWELLST.JOSEPHSTURGISTHREE RIVERSANGOLA INDIANAELKHART INDIANAKENDALLVILLE INDIANA What time of day works best? Morning (9-12)Afternoon (12-5)Evening (After 5) Name (required) Phone (required) Your Email Notes [recaptcha id:recaptcha]
