Schedule an Eye Care Appointment in Fredericksburg, VA

Also serving Stafford & King George

If you do not see the appointment type you need or the doctor you wish to schedule with, please complete the appointment request form at the bottom of the page or call our office. If you have an eye related emergency do not use the forms below. You must contact our office directly at 540-371-2020.

---

This form should only be completed if you were unable to self-schedule above.

Appointment Request Form

Full Patient Name *

Please List Other Family Members Who Need An Appointment Also:

Email Address *

Best Contact Number *

Appointment Date(s) Requested *

Best Time to Contact
Anytime Morning Afternoon Evening

Are you an existing patient? - Select One - Yes No

How were you referred? - Select One - Doctor referral Friend/family referral Google search Facebook Instagram Signage Doctor referral Radio Other

Reason(s) for Appointment(s) *