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Kittery Office
(207) 439-0410
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Wells Office
(207) 646-3900
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Ophthalmologists
(207) 439-4958
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Home » Contact Us » KOA Appointment Request Form

KOA 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 note that our ophthalmic surgeons do not accept appointment requests.

  • 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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IMPORTANT CORONA VIRUS UPDATE

Due to recent medical developments, we are currently not providing routine examinations, but patients can still contact our office regarding any emergencies, concerns or questions.

For any urgent glasses or contact lens related matters, please call our office at 207-439-0410. We are making every effort to avoid unnecessary traffic in the office. If a visit is essential, it can be scheduled. Curbside pickup is available.