Cascadia Eye Care - Schedule Appointments

Please fill out the form below and we will contact you with an appointment time.
Required fields are marked with asterisks (*).

PATIENT INFORMATION:

Patient Name *
Contact Name
Relation to Patient:
Home Phone *
Work Phone:
Email Address

Are you currently a patient at Cascadia Eye Care? *
Yes No

What is the reason for the appointment? *

Vision and eye health exam for glasses

Vision and eye health exam for glasses and contact lens

Medical concern

Other concern

What concerns, if any, would you like to discuss with the doctor?

Cascadia Eye Care office hours are as follows:

* Appointments with doctors are usually available Tuesday - Saturday

Scheduling Information:

Please enter up to three times that would work well for you.
(e.g., "Thursdays before 3pm").

First Choice:

Second Choice:

Third Choice:

Our staff will contact you by phone within 24 hours.

NOTE: It may take a moment to submit your information. Please wait for a confirmation message.