REQUEST AN APPOINTMENT Contact us today to scheduleCall 702-362-3900 or fill out the form below.If this is an Emergency Referral please contact our office at 702-362-3900.First NameLast Name*Email* Phone*Time* : HH MM AM PM Date* Date Format: MM slash DD slash YYYY Appointment Type*: Cataract Exam LASIK Consultation Follow Up/Post-Op Annual Eye Exam Contact Lens and/or Glasses Exam Medical Eye Exam Hand Surgery Plastic and Reconstructive Surgery Podiatry Orthopedic Rapid Opioid Detoxification Other How Did You Hear About Us? TV RADIO NEWSPAPER ONLINE OTHER Select oneReferring DoctorDo you have a referring doctor, such as an optometrist, ophthalmologist, primary care doctors? (It's ok if you don't. We just want to include them in your care).Attach Patient's Any File (Optional)File type: docx, pdf, jpeg, jpg or png. Max file size: 20MB If your file is a different type please change the type or contact 702-362-3900.NameThis field is for validation purposes and should be left unchanged.
