You May Be A Good Candidate for Optometric Vision Therapy!Based on the answers you provided, you may benefit from Vision Therapy. Complete the form below, and someone from our staff will contact you soon to schedule your appointment. Thank you! Please use this form for general information purposes only. DO NOT send personal health information through this form. Specific patient care must be addressed during your appointment.Name*Patient's NameReason for VisitHow Did You Hear About Us?Phone*Best Time/Day to Reach You to Confirm Appointment?CAPTCHACommentsThis field is for validation purposes and should be left unchanged.