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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
.

Complete the following form:

  • 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.
  • Privacy & Billing Policy

  • Privacy Policy
    Viewpoint Eye Care follows the Alberta Government’s Privacy Act. This legislation exists to protect your personal information from improper disclosure. The information we collect and disclose is used only for the treatment and management of your vision and eye health. Please refer to our Privacy Policy manual for more information regarding this practice. I agree to Viewpoint Eye Care collecting, using and disclosing personal information about me as outlined in this privacy policy. I understand that all fees charged are my responsibility, and if Alberta Health Care, or my third party insurance rejects my claims, I will pay the full amount.
    Billing Policy
    I understand that all fees charged are my responsibility, and if Alberta Health Care, or my third party insurance rejects or leaves my claims pending, I will pay the full amount.
  • This field is for validation purposes and should be left unchanged.