Appointment Request Form

Monday: 9:00 AM - 5:00 PM
Tuesday: 9:00 AM - 7:00 PM
Wednesday: 9:00 AM - 5:00 PM
Thursday: 10:00 AM - 7:00 PM
Friday: 9:00 AM - 1:00 PM
Saturday: 9:00 AM - 1:00 PM
Sunday: Closed

Name: St. Clair Eye
Address: 3443 County Line, Richmond, MI, 48064, US
Price range: $000 - $300

Please fill in the form below to setup an appointment.
Location*
Reason for Appointment
Please provide a reason for your appointment. Details are stored securely and not sent by email.
Preferred Date & Times*
Please let us know when you would prefer to have your appointment. Our hours are listed on our location page.
Patient Type*
- New patient
- Returning patient
Please let us know if you are a new or existing patient.
Name*
First Last
Phone*
Email*
Best Time to be Reached for Confirmation*

: HH

MM
Comments
Name
This field is for validation purposes and should be left unchanged.

St. Clair Eye