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To adhere to COVID-19 guidelines, all patients must wear a mask that covers their mouth and nose for the duration of the time in our office. Please be advised, a screening and temperature check will take place prior to entry. If you arrive early for your scheduled visit, you may be asked to wait until your appointment time before entering the building. We also request that any accompanying family, caregivers, and drivers remain outside for the duration of the visit, unless their presence is essential. Curbside pick-up for both contacts and glasses is available.

We are making every effort to assure your visit to our office is comfortable and safe. We thank you for your cooperation and understanding.

Kittery Office
(207) 439-0410
Appointment
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 urgent eye 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.