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Our Location

10071 Wadsworth Pkwy, Ste 200
Westminster, CO 80021

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.

WE REQUIRE APPOINTMENTS FOR ALL VISITORS. DO NOT ENTER THE BUILDING WITHOUT AN APPOINTMENT. You must cancel your appointment if you have any symptoms of illness.

The State of CO, Jefferson County, and the City of Westminster require face coverings within businesses and we will continue to require face coverings be worn tightly fitting over your nose and mouth. Please see our website for detailed safety operations in line with the CDC requirements.

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. Pink eye symptoms may be related to COVID-19.