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Home » Contact Us » Appointment Request Form

Appointment Request Form

If this is an emergency, do not contact us via email, please use our emergency contact information.

Complete the following 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.
  • :
  • This field is for validation purposes and should be left unchanged.

At Lakeside Vision & Optical, we are committed to providing all of our patients with exceptional care. When a patient cancels without giving enough notice, they prevent another patient from being seen.

Please call us at (972)985-3638 by 2:00 p.m. on the day prior to your scheduled appointment to notify us of any changes or cancellations. To cancel a Monday appointment, please call our office by 2:00 p.m. on Friday. If prior notification is not given, you will be charged $30 for the missed appointment.