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Appointment Request

The first step towards better vision is to schedule an appointment. Please contact our office by phone or complete the appointment request form below. For immediate response, please click here to talk to a scheduling coordinator at one of our conveniently located clinics.

Please do not use this form to cancel or change an existing appointment.

Emergencies

One of the Oregon Eye Specialists physicians is on call 24 hours a day, seven days a week. If you have an emergency during office hours, please call the office where you are normally seen and our staff will make arrangements for you to see the doctor as soon as possible. If you have an urgent eye care problem after hours, either call the office where you are normally seen and listen to the recorded instructions or call our answering service at (503) 499-5802.

Emergencies include: sudden loss of vision, pain, foreign objects in the eye, floaters or flashes of light.


* Required Fields

Note: Messages sent using this form are not considered private. Please contact our office by telephone if sending highly confidential or private health information.

Name *
Phone *
E-Mail
Are you a current patient?
Yes No
Address
City
State
Zip
Best time(s) to call?
Morning Noon Afternoon Evening
Which office location(s) would you prefer for your appointment? *
Aloha
Newberg
Good Samaritan
Providence-Portland
Gresham
St. Vincent
Lake Grove
Tualatin-Meridian Park
Preferred day(s) of the week for an appointment?*
Any Day MON TUE WED THURS FRI
Preferred time(s) for an appointment?*
Any Time Morning Noon Afternoon
Please describe the nature of your appointment (e.g., consultation, check-up, etc.)
Note: Messages sent using this form are not considered private. Please contact our office by telephone if sending highly confidential or private health information.

Click the button below to submit your form. If you are not redirected to a thank you page, please check that you have filled all required fields above and resubmit.

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