myspace visitor counter

Welcome to the Orange County Eye and LASIK Institute! You have made a great choice by visiting our page. We promise to treat you like family and provide you the best customer service. Please call our office or fill the appointment request form below. Our scheduling coordinator will contact you to confirm your appointment.

If you make the request after hours or during weekends, we will contact you the next business day.

Please do not use this form to cancel or change an existing appointment. Thank you!

 

Call Now At: 949-450-2020


*Items in bold are required.
Name:  
Address:
City:
State/Province:
Zip/Postal:
Email:
Phone:  
Are you a current patient?
Best time(s) to call?

Preferred day(s) of the week for an appointment?
Preferred time(s) for an appointment?
Please describe the nature of your appointment (e.g., consultation, check-up, etc.):

Note: Messages sent using this form are not considered private. Please contact our office by telephone if sending highly confidential or private information.