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Appointment Request Form

If this is an emergency, calling our office is best at (541) 389-4774. If after hours, use our emergency contact Orion Eyecare at (541) 548-7170.

To request your next appointment, please call (541) 389-4774 or complete the form below and let us know the most convenient time and date for you. Please don’t forget to include contact details so we can follow up with you to finalize your request. For immediate assistance on appointment scheduling please call our office.

  • Please fill in the form below to setup an appointment.
  • Please provide a reason for your appointment. Details are stored securely and not sent by email.
  • Please let us know when you would prefer to have your appointment. Our hours are listed on our location page.
    Please let us know if you are a new or existing patient.
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  • This field is for validation purposes and should be left unchanged.