every child should have an eye exam by age 5!

But what if they…

have no complaints

• Many don’t realize how they see is not normal
• May not say anything because they don’t want to wear glasses
• Don’t know how to verbalize their vision problems

passed a vision screening

• Farsightedness, astigmatism & most importantly binocular vision dysfunction are most often missed during screenings
• For younger patient, it’s often difficult for non eye care professionals to distinguish if they truly cannot read the chart or if they just do not want to participate for various reasons

have 20/20 vision

Most eye exams check to see if a patient is nearsighted, farsighted or has astigmatism. We go beyond that.
We perform Functional Vision Exams which allow us to diagnose Binocular Vision Dysfunction that can cause learning difficulties and migraines among other things

Appointment request:

First & Last Name of patient (as shown on insurance card if applicable):

Phone number:

Your Email:

Date of Birth:

Exam Type:

I would like to try contacts for the first time

Vision Plan:

Vision plan ID number (if known) + primary person's date of birth if it is not yourself:

Medical Plan (many patients have vision benefits that they are not aware of. Providing this information may result a lower co-pay). Please choose an option below:

Medical plan ID number (if known) + primary person's date of birth if it is not yourself:

Preferred day(s):
MondayTuesdayWednesdayThursdayFridayNo preference

Preferred time of day:
AMPMFirst available

If patient is under 18, please include your name & relationship to patient:

Questions/Comments:

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