Request an Appointment

Online Appointment Request

Is the patient New or Returning?

Patient’s Name *

Date of Birth *

Name of Parent or Guardian if applicable:

Phone Number *


What time and date works best for you

Appointment Details

Select Your Location: *

Thank you for choosing Optic Gallery for your eye care needs!

Our offices will reach out to you shortly to schedule an appointment.

If this is an after-hours emergency, please head to your nearest emergency room.