Request an Appointment

Please fill out the form below, and we will contact you with our available openings. If you have days of the week or times of the day that typically work better for you, please list those in the your message. We are honored to have you “Come Here, See Clear” with us at C Klear Vision Optique.

Name

First Name

Last Name

Date of Birth

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Phone

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Email Address

Message

Insurance Coverage

Please enter BOTH medical and vision benefit information (if both apply), such as provider and member ID. If you have no insurance coverage, please type "none".