Appointment Scheduler

Please select a provider.

Please select a date and time

All fields are required

Personal information

All fields are required

Male Female

Are you an existing patient?

Additional Notes

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What is the main reason for this visit?

Insurance Information

If you have a vision plan separate from your medical insurance, Style Optique is in-network with Vision Service Plan (VSP) only.

Please provide your current medical insurance information. Some medical insurance plans include routine vision benefits, and having your information on file helps us verify your coverage before your appointment. If you have medical insurance, please provide it even if you also have a separate vision plan

Is the patient the subscriber?

Review and Submit

Please review then click submit.

1. Personal Details
- First Name:
- Last Name:
- Dob:
- Email:
- Phone:
2. Appointment details
- Reason for visit:
- Appointment time:
- Provider:

Please select a provider.

What is the reason for this visit?

Please select a date and time

Personal information

Additional Notes

Insurance Information

Review and Submit

1. Personal Details

2. Appointment details