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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) -Routine Medical Exam (diabetes, glaucoma check-ups) -Medical Concern (pain, redness, infection, foreign object. *Please call us for urgent scheduling)
  • 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.
  • This field is for validation purposes and should be left unchanged.
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Family Vision Center will follow Jefferson County guidelines for reopening and managing eye care needs during the spread of COVID-19.

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 for an urgent appointment.

You may now schedule routine eye exams. Please see our website for detailed news on our new safety operations and requirements in line with CDC precautions. ALL patients and visitors to our office must wear a face mask or cloth covering nose and mouth.