HVC - Schedule Appointments

"Neatest way to make an appointment ever!"
-Kaye Jones Ratliff

Schedule Your Appointment Online:

Please fill out the form below and we will call or email your appointment confirmation on the next business day.

Or you can call our office today if you prefer to personally schedule your appointment at a more convenient time.

Fill out the Medical History Questionnaire online or print it out and bring it to your appointment.

Required Fields Request Your Tentative Appointment*
*Date
*Office Location & Time	OR
	We will email you back with conformation or alternative appointment times. Appointment is not valid until conformation is received.

Contact Information
*First Name
*Last Name
*Home Address 1
Home Address 2
*City
*State
*ZIP Code
*Home Phone	()
Work Phone	()
Cell Phone	()
*How would you like us to notify you of your appointment?	Telephone	Email

Email Address

Personal Information
*Date of Birth
Name of Medical Insurance
Name of Vision Insurance	We accept insurance.
*Are You A	New Patient?	Established? had an appointment within the past 3 years	Established? 3 years or more since your last appointment

Please let us know about any questions, concerns, or ideas that might make scheduling an appointment online easier.

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This webpage was last updated on October 23, 2006