(417) 886-EYES (3937) • (800) 995-3180 size-upsize-normalsize-down

(417) 886-EYES (3937) • (800) 995-3180

Appointments & Patient Registration Forms

If you would like to request an appointment, please complete the form below and someone from our office will contact you shortly to confirm your appointment details.

Until you have been contacted by a representative from our office, you do not have an actual appointment.

Please do not attempt to request a "same-day appointment" via this web site; however same-day appointments may be available. Pleasecall our office call our office for further details.

Note: To serve you better, all fields are required for the following form unless marked as optional.

Do you already have an appointment?
Click on the link below, print the form, fill it out and bring it with you to the office.


Patient Information

Format: mm/dd/yyyy

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