Appointment Request

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Coming in for an appointment? Here’s a checklist of things to bring along to ensure you have the best eye care experience.

  1. If you take any medications, please bring in a list.
  2. Are you using insurance? Bring along your medical and vision insurance cards
    • We like to keep the medical insurance on file in case you come in for any medical reasons.
  3. Any eyewear you currently use, such as glasses, sunglasses or contact lenses.
  4. • Knowing what kinds of eyewear you use will help us cater your exam to your lifestyle.
  5. Are you a new patient who wears contact lenses? Please bring in your old prescription or any old boxes with you. • It makes it easier for us to know your old prescription, brand, and lens style.
  6. Fill out your forms ahead of time!
    • You can fill out your forms online so you’re all ready to go when you come in for your appointment!

The following secure links can be used to fill out your forms online:

  • HIPAA Acknowledgement (View Privacy Policy)
  • Patient Responsibility Disclosure
  • Full Patient Form (New patients or if your last exam was more than a year ago)
  • Short Patient Form

Alternatively, if you do not fill out the forms ahead of time, please plan to come in for your appointment 10-15 minutes early to fill out your forms.

Have any copays? Please note they are due at the time of service.

Submit the following information to request an appointment


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Hours of Operation


Cudahy Office


9:00 am-5:00 pm


9:00 am-7:00 pm


9:00 am-5:00 pm


9:00 am-5:00 pm


8:00 am-3:00 pm


8AM-1PM 2nd and 3rd Saturdays/Month