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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 a reason for your appointment. Details are stored securely and not sent by email.
  • Please let us know when you would prefer to have your appointment. Our hours are listed on our location page.
    Please let us know if you are a new or existing patient.
  • :
  • This field is for validation purposes and should be left unchanged.
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We are currently offering remote vision therapy sessions due to the State of Colorado order to Shelter at Home. Once the order has lifted, we can’t wait to see you at our new office location: 2800 Valmont Rd, Boulder, CO 80301.