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Appointment Request Form

  • 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.
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To our valued patients:

We are taking extra measures to maintain office cleanliness to ensure the health of our patients and staff.

Patients may decide if they wish to wear a mask.

If you need to pick up your glasses please schedule an appointment.

Please call the office at (920) 968-7546 if you feel you have an emergency. Additionally, don’t hesitate to contact us if you need to order a supply of contacts. We can ship them directly to you. Check out our website if you may be interested in purchasing glasses online through Proper Optics.