Appointment Request


The first step towards better vision is to schedule an appointment. Please contact our office by phone @ (205) 397-9400 option 2  OR complete the appointment request form below. Please specify location and  If you would like to schedule your appointment with a specific doctor in our practice, please specify the doctors name in the form below. Our scheduling coordinator will contact you to complete your request.

Vestavia Location : 1009 Montgomery Highway, Suite 200 - Vestavia Hills, AL 35216

Grandview Satellite Location: Grandview Physicians Plaza -3686 Grandview Parkway, Suite 100 , Birmingham, AL 35243

Please do not use this form to cancel or change an existing appointment.

* Please note, We do not accept VSP insurance; Medical Health Insurance Policies only

 
*Items in bold are required.
Are you a current patient?


Which office location(s) would you prefer for your appointment?


Preferred day(s) of the week for an appointment?

Preferred time(s) for an appointment?

Please describe the nature of your appointment (e.g., consultation, check-up, etc.):

Note: Messages sent using this form are not considered private. Please contact our office by telephone if sending highly confidential or private information.

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Contact Us.We encourage you to contact us with any questions or comments you may have. Please call our office or use the quick contact form.