Appointment

Walk-Ins

We do welcome walk-ins, however, appointments are our priority and walk-in appointments are subject to the next available appointment.

Make An Appt By Calling Or Filling Out The Form Below

Phone: 214-872-4177
Fax: 888-818-1450

Appointment Request Form

Please fill out the form below and submit for an appointment request. Please make sure the form is submitted by looking for verification.

Please Note: Form has been tested with Internet Explorer, Chrome, Firefox & Safari.

What do you need to be seen for? Check all that apply.

If you are needing a contact lens fitting and evaluation, have you worn contacts before?

DAY(S) PREFERRED (Required) - Please pick more than one.


*We are closed Sundays and Mondays

Doctor Preferred (Required)

Time(s) Preferred (Required)

Please Fill Out The Fields Below If You Are Using Medical AND/OR Vision Insurance

Medical Insurance





Vision Insurance


OUT OF NETWORK WITH: Spectera and Davis Vision. (PATIENTS CAN FILE OUT OF NETWORK CLAIM)





Additional Notes For Wink Eye Care Staff

Please look for verification after submitting


Secure Online Patient Form

BE GREEN, DO IT ONLINE AT YOUR CONVENIENCE!

In an effort to reduce paperwork and be more green, we have a secure online patient form for you to fill out before coming to the office for your appointment. Please take about 10 minutes to do so before coming in. Click the link below to launch the form.

CLICK HERE TO GO TO THE SECURE ONLINE PATIENT FORM

When you come in for your appointment, if you have glasses or extra contacts, bringing those will allow us to better serve you. Also remember your Driver’s License, Student/Staff ID and Insurance Card (if applicable).

Thanks and we will see you soon!

Trouble Shooting: “I Keep Getting An Online Submission Error!”

If you get an error after submission from the form above, please copy, paste, and fill out the following info and email us at info@winkeyecare.com. Thank you. We apologize for the inconvenience.

  1. First and Last Name
  2. Email Address
  3. Phone Number
  4. Appt Day Preferred (Tuesday – Saturday)
  5. Appt Time Preferred (Morning or Afternoon)
  6. Type of Medical and/or Vision Insurance
  7. Glasses, Contacts, Both or Medical Evaluation
  8. Public Educator or Military Affiliation? (Proper ID required) (Yes/No)

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