AVA appointment request

Please note that submitting appointment requests do not guarantee an appointment for the desired time. Our desire is to serve as many patients as possible and we will do our best as our doctors and staff are available. Thank you for your patience!

Please complete the request form below

Phone Number *
Phone Number
Best number to reach you regarding your request.
Preferred Doctor *
Do you currently wear contacts? *
Do you currently wear glasses? *
Are you a diabetic? *
Desired Appointment Date *
Desired Appointment Date