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Appointment Request Form

Contact our eye care staff to book or request an appointment by filling out the information below. If this is an eyecare emergency, please call the office at 810-231-5800 for immediate assistance. We look forward to hearing from you.

  • 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.