Appointment Request

If you are having a medical emergency,
please call 9-1-1 or go directly to the Emergency Room.

Do not use this form to request an urgent appointment for an eye emergency or issue, update or change appointments, transmit or request any medical information, transmit or request any personal information, request prescriptions or prescription refills. Please contact our office directly by phone at (352) 787-1956.

If you have eye pain or sudden loss of vision, please contact our office at (352) 787-1956.


Please fill in all fields before submitting this form. All submitted requests will be handled during normal business hours.

This form is intended for general questions only and is not a secure method of communication.