Please fill out the form below and we will contact you with an appointment time. Required fields are marked with asterisks (*).


Patient Information

Patient Name: *   
Contact Name:   
Relation to Patient:   
Home Phone: *   
Work Phone:   
Email Address   
 
Are you currently a patient of Dr. Tsai's? *
Yes  No
 
What is the reason for the appointment? *
Vision and eye health exam for glasses wearer
Vision and eye health exam for glasses and contact lens wearer
Medical concern
Other concern
 
What concerns, if any, would you like to speak to the doctor about:

Office Hours

Monday: 10am-6pm
Tuesday: 10am-6pm
Wednesday: 10am-6pm
Thursday: 10am-6pm
Friday: 10am-6pm
Saturday: 10am-4pm
Sunday: Closed

Scheduling Information

Please enter up to three times that would work well for you (i.e. Thursday mornings" or "Wednesdays around 3pm").

First Choice:   
Second Choice:   
Third Choice:   

Confirmation

Our staff will contact you by phone within 24 hours.


It may take a moment to submit your information. Please wait for a confirmation message.

  

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