Schedule Your Visit

Please submit the form or call (973) 579-2020

If you’re a new LASIK or vision correction surgery patient, you can self-schedule your consultation instantly by clicking below.

All other patients, please use the appointment request form.

Appointment Type*
Full Name*
Date of Birth
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Email Address*
Phone Number*
Date
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How did you hear about us?
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Did your Eye Doctor talk to you about Eye Care Northwest?
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Your Eye Doctor
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Specific Requests (hidden field)*
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Preferred Date (original, now hidden field)*
Name
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