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Home » Contact Us » Appointment Request Form

Appointment Request Form

If this is an emergency, do not contact us via email, please use our emergency contact information.

To request your next appointment, please complete the form below and let us know the most convenient time and date for you.  Please don't forget to include accurate contact details so we can follow up with you to finalize your request.

  • Please fill in the form below to setup an appointment.
  • Please provide a reason for your appointment. Details are stored securely and not sent by email.
  • Please let us know when you would prefer to have your appointment. Our hours are listed on our location page.
    Please let us know if you are a new or existing patient.
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  • This field is for validation purposes and should be left unchanged.

Hello Friends.

I am happy to announce my retirement effective May 29, 2021.  Starting June 14th, your records are being transferred to Dr. Chandra Williams at River City Vision Center located at 12961 North Main St. #203, Jacksonville, FL, 32218. 

Her phone number is (904)696-2027.  You will also still be able to call my phone number on your prescription cards and it will transfer to her office. 

Thank you for the privilege of being your eye doctor and getting to know you. 

All the best to you.Adele Paul, O.D.