Appointment Center

Simply fill out the form below to confirm or reschedule your appointment and we'll respond within 24 hours (next business day). If your appointment is within the next 48 hours (two business days), please call us at our North Carolina office location where your appointment is scheduled.

 

Confirm or Reschedule an Appointment

This form is for patients who are currently scheduled for an appointment. If you do not yet have an appointment, please visit our New Patient Zone to schedule an appointment.

Note:  This form is for NON-emergencies only.  Please do not use this form if you are experiencing an eye injury or other eye health complication.  Instead, please call our office at (919) 863-2020.

Purpose of Request

  By completing this form, I am confirming patient's appointment.
  Patient is not able to keep appointment. Please contact me to reschedule.

Appointment Info

My Current Appointment:

(If your appointment is before or after dates shown, please call to confirm.)
 
Doctor Office Location

Patient and Contact Info

Patient's Name(s): 
My Relationship: 
   
My First Name: 
My Last Name:
 
Preferred Contact Method(s):

Enter Special Request or Comments Below: