Request for Consultation with the

Zeiter Eye Medical Group

Please complete the following form to request an appointment with a Zeiter Eye Medical Group Eye Care Professional. Once our staff has received your request, we will contact you within 24 hours to schedule a convenient appointment that fits your schedule.

    Your First Name (required)

    Your Last Name (required)

    Your Email (required)

    Your Contact Telephone (required)

    I am interested in scheduling a Consultation
    Yes, please schedule me for a Consultation

    My Preferred Appointment Day is

    My Preferred Appointment Time is

    I am interested in

    The office that is most convenient for me is

    Please tell us how you heard about us

    The reason for your consultation is

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    Schedule An Appointment

    Need to schedule an Vision, Oculoofacial or hearing appointment near you? Use our online appointment form to request the location and type of service. Click here to request your appointment!

    Are you a new Patient?

    Save time when you arrive by downloading your Patient Information Form before your first appointment. Click here to access your New Patient Form!

    Oculofacial Consultation

    Request an appointment with a Zeiter Eye Medical Group reconstructive and cosmetic surgeon for your Oculofacial Consulation. Click here to get started now!

    FREE Lasik Consultation

    Request an appointment with a Zeiter Eye Medical Group Eye Care Professional for your FREE Lasik Consulation. Click here to get started now on your new vision!

    Financing & Payment Plans!

    Zeitere Eye Medical Group offers financing and payment plans through Care Credit. Click here to learn about your payment options!

    Patient Survey

    Zeitere Eye Medical Group is proud to offer the highest quality medical care and service and we want to hear about your experience. PLease take a few moments and complete our online patient survey. Click here to tell us about your visit.