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We offer the convenience of requesting appointments online!

One of the most important aspects of patient care here at Visionhealth Center is to always put the patient's needs first, and we recognize that convenience is large part of great customer service. Therefore, we now offer our patients the ability to arrange for an appointment online.   Just let us know what days and times work best for you, and a staff member will schedule your appointment and call you back to confirm the date and times.  It's that easy!

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Part I.  Patient Information: 

1. What is your name?   

 

2. If the appointment is for another family member, what is the patient's name & relationship to you? 

 

 

3. What is the age of the patient? 

 

4. Are you (or your family member) a new patient or a former patient of Visionhealth Eye Center?

                      New Patient                           Former Patient

 

Part II. Appointment Request  

Please fill out one of the boxes below to request either our first available appointment (left box) or a specific day and time (right box).

A. Please schedule me for your first available appointment.


This is the best option to see Dr. Harl as quickly as possible.   (However, if you prefer to specify a day and time, please skip Section A and go to Section B to the right to request a specific appointment time.) 

I want the first available appointment in the morning.

I want the first available appointment in the afternoon.

Please schedule me for your first available appointment, either mornings or afternoons.

I understand your office will call me to confirm the day and  time.

 

B. Please schedule an appointment for me during the following times:


1. What weekday works best for you? 

 Between 8:00 and 5:00 on

   Monday    Wednesday     Friday  

  Between 12:00 and 7:00 pm on 

      Tuesday    Thursday            

2. What time do you prefer? 

On Mondays, Wednesday, and Fridays, you can request appointments on the hour or half hour in the mornings between 8:00 am and 11:30 am or in the afternoons between 1:00 pm and 4:30 pm.   

On Tuesdays and Thursdays  you can request appointments on the hour or half hour between 12:00 pm and 6:30 p.m.   

Please note that if the specific times you request are not available, we will notify you when we call to confirm and do everything we can to find a convenient alternative.

First time preference

Second time preference

 

 

Part III.  Additional Information. What is the reason for the appointment? (annual eye exam, eye infection, problems reading, itchy or watery eyes, etc.)  You may also use this space to provide us with any additional information you feel will be helpful to us in serving you.

 

Part IV.  Conformation:  We will schedule your exam at the time you requested and call you back to confirm the appointment time.

What is the best telephone number to reach you at during the day?

Daytime Telephone

Alternate Telephone

 

If you need to reach us to discuss your appointment, please call our office at 732-5575.  We will be glad to assist you!

Thank you for allowing us to serve you!

 

      

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