Schedule An Appointment At Poplar Spectacles Optometry

At Poplar Spectacles Optometry, we provide the highest quality service to all our patients. Use the form below to request your appointment. Please indicate your preferred date and time. Please note that we will reach out to you first to confirm your appointment or to provide you with an alternative date. You may also call us to request an appointment. Thank you!

Date of Birth

Phone

Preferred Method of Contact

PhoneEmail

Desired Appointment Date

Desired Time of Appointment

If your requested appointment is not available, what is your preferred day of the week and time?

Do you have Vision Insurance?

YesNo

If yes, what is your vision plan and member ID?

Do you have Medical Insurance

YesNo

If yes, what is your Medical insurance and member ID?

Are you interested in contacts?

YesNo

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