Skip to content
Find Us at Fairbanks
(907) 331-3013
Book Appointment
Home
About Us
Our Staff
Book an Appointment
Our Eye Doctor
Family Eye Care
Comprehensive Eye Exams
Contact Lens Exams
Eye Disease Management
Medical Eye Care
Dry Eye Treatment
Eye Surgery Care & Referrals
Insurance
Hours & Location
Emergency Eye Care ( Office Hours )
Appointment Request Form
Thanks for contacting us! We will get in touch with you shortly.
Please fill in the form below to setup an appointment.
Reason for Appointment
*
Please provide a reason for your appointment. Details are stored securely and not sent by email.
Preferred Date & Times
*
Please let us know when you would prefer to have your appointment. Our hours are listed on our location page.
Patient Type
*
New patient
Returning patient
Name
*
First
Last
Phone
*
Email
*
Best Time to be Reached for Confirmation
*
Hour
Minute
AM
PM
AM/PM
Comments
Submit