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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 include your date of birth and address in the comment section below.

  • 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.

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Welcome back to all our patients!

Our office is now open by appointment ONLY.

Under the guidance of The College of Optometrists of Ontario and the Ministry of Health, we will be following strict guidelines to make sure we keep you and our staff safe.

Please click the OFFICE UPDATES tab to see our updated policies and procedures.

We look forward to seeing you soon.

Harbourview Optometry Centre