Flaum Eye Institute / LASIK & Advanced Vision Correction / Schedule an Appointment

Schedule an Appointment

You can use this form to request a pre-operative evaluation appointment with physicians at the Flaum Eye Institute Refractive Surgery Center only.

Request A Non-Urgent Appointment

For questions about your appointment, please contact us at (585) 273-2020. Use this form to request a non-urgent appointment only. All requests will be processed within 24 hours during regular business hours, Monday - Friday, 8:00 am-4:30 pm.

place field "FirstName" below

Name

First Name

place field "LastName" below

Last Name

place field "Street" below

Address

Street

place field "City" below

City

place field "State" below

State

place field "Zip" below

Zip Code

place field "HomePhone" below

Contact Information

Home Phone

place field "WorkPhone" below

Work Phone

place field "Email" below

Email Address

place field "ContactPref" below

Contact me between 8:00 a.m. and 4:30 p.m. via:

Home Phone Work Phone Email

place field "Contacts" below

Your Eyes

Have you worn contact lenses during the last 5 days?

Yes No

place field "ContactsType" below

If yes, what kind?

place field "DayFirst" below

Scheduling Preferences

Please indicate your first choice for day and time.

Day of week

place field "TimeFirst" below

Time of day

place field "DaySecond" below

Please indicate your second choice for day and time.

Day of week

place field "TimeSecond" below

Time of day

place field "PromoCode" below

Additional Information

Promo Code

place field "Source" below

How did you hear about Flaum Eye Institute?

Our Privacy Policy