Appointment Request Form Basic form for clients to request an appointment with the practice. Please fill in the form below to setup an appointment.Patient Type*New patientReturning patientPlease let us know if you are a new or existing patient.Preferred Doctor*No PreferenceDr. Darren Hatchard B.Sc., O.D.Dr. Ignacio Salvati, Optometrist, M.D. (Argentina)Dr. Brian Sklapsky A.B., O.D.Dr. Hayley Valgardson B.Sc., O.D.Reason for Appointment* Eye Exam Contact Lens Exam Medical Exam Dry Eye Consult LASIK Consult Other Please provide a reason for your appointment. Details are stored securely and not sent by email.Preferred Date* Date Format: MM slash DD slash YYYY Preferred Time*MorningAfternoonName* FIRST LAST Phone*Email* CommentsNameThis field is for validation purposes and should be left unchanged. This iframe contains the logic required to handle Ajax powered Gravity Forms.