Get Started - Eyeris

Good Decision!
Your Eyes Thank You!
Let’s start by getting your basic information!
*
First Last
Email Address*
Phone*
*For doctor contact & SMS updates on your appt. Standard TXT rates may apply
Zip Code*

Next Up!
So, when do you want to see a doctor?*
Date Format: MM slash DD slash YYYY
What time?*
How far are you willing to travel to be seen on your schedule?*
- 5 Miles
- 10 Miles
- 20 Miles
- 30 Miles

Last Step!
Medical/Vision Insurance Information
Just Basic Carrier Information
We only want to send you to a Doctor that takes your insurance. If you are prepared to use of Out Of Network, please select i'm paying Cash!
Vision Carrier*
Health Provider*
- I'M Paying Cash*
* Selecting this means that you will pay at the time of the appointment and/or if OON, will contact your insurance for reimbursement

Good Decision!