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Our Location

10071 N. Wadsworth Pkwy, Ste 200
Westminster, CO 80021

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Home » Contact Us » Appointment Request Form

Appointment Request Form

If this is an emergency, do not contact us via email, please use our emergency contact information.

Complete the following form:

  • Please fill in the form below to setup an appointment.
  • Please provide the main reason for your appointment. Details are stored securely. -Annual Eye Exam (glasses and contacts) -Routing Medical Exam (diabetes, glaucoma, etc) -Medical Concern (pain, redness, infection, foreign object)
  • Our Hours: Mondays-closed, Tuesdays- 10am-7pm, Wednesdays- 8:30am-5:30pm, Thursdays- 8:30am-5:30pm, Fridays- 8:30am-5:30pm, Saturdays- 8am-1pm, Sundays-closed.
  • Please include the name of your Vision Insurance and have your member ID information ready. We will need to verify that your plan is accepted at our office. Examples: VSP (Vision Service Plan) EyeMed (plan specific) Spectera *Or you may have vision coverage under your medical insurance.
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  • This field is for validation purposes and should be left unchanged.
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As Jefferson County deals with the spread of COVID-19… our office will remain open for essential and emergency eye care only.

If you have eye trauma, foreign object, scratch, pain, flashes of light, sudden vision changes, or have broken your only pair of glasses, please call us at 303-427-2020. If you are running out of contacts, we are extending prescriptions until we can schedule your annual exam.

PLEASE CALL IF YOU NEED HELP. Leave a message and we will respond ASAP.

All routine or non-essential eye exams until April 30th have been cancelled. Our staff will reach out to you to reschedule. Thank you and stay safe!