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Dry Eye Center

Keratoconus & Specialty Contacts
Low Vision Care

We’ve moved to a new location12911 120th Ave NE G105, Kirkland, WA 98034. We are conveniently located across the street from the Evergreen Health Center ER and north of the new Village at Totem Lake, Totem Lake Boulevard. Look for the blue Pro Ortho sign, building G.

Patient Registration Form

Dry Eye Center Keratoconus & Specialty Contacts Low Vision Care

Home » Contact Us » Appointment Request Form

Appointment Request Form

If this is an emergency, do not contact us via email, please use our emergency contact information.

To request your next appointment, please complete the form below and let us know the most convenient time and date for you.  Please don't forget to include accurate contact details so we can follow up with you to finalize your request.

  • 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.