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Home » Online Appointment Request Form

Online Appointment Request Form

If this is an emergency, do not contact us via email, please call 911 or go to the nearest emergency room.
  • Please note this is an appointment request; a staff member from the office will be contacting you to confirm this request. You are not booking an appointment by submitting this request.
  • Preferred Dates and Times

    Please note we do not schedule appointments between 1:00 - 2:00 PM.
  • MM slash DD slash YYYY
  • No Show Policy

    Triangle Family Eye Care will assess a fee of $35 for anyone who schedules an appointment and fails to give our office a 24 hour cancellation notice. The same fee will be assessed for any no show appointments.
  • This field is for validation purposes and should be left unchanged.