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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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We appreciate your patience as we maintain our office procedures and schedule to keep everyone as safe as possible.

* Our lobby is open

* Masks, covering both nose and mouth will continue to be required while inside our office

Thank you again for your patience as we work to provide for your eye needs and balance that with patient and staff safety. We will continue monitoring the information from the CDC and the Indiana Optometric Association to make the most informed decisions.