Expert Eye Care. Quality Eyewear. Service Excellence.
  • 3480 El Camino Real
  • Santa Clara, CA 95051
 | (408) 247-5102  
 

Schedule An Appointment

Frequently Asked Questions

Schedule By Phone

To schedule an appointment by phone, please call us at (408) 247-5102.

Request An Appointment

Thank you for choosing Optima Optometry for your eye care. To request an appointment online, please fill out and submit this form:

Patient Information


Patient Status: New Patient Returning Patient

Patient Name:

Parent/Guardian Name: (If patient is under 18 years of age)

Street Address 1:

Street Address 2:

City: State: Zip Code:

Phone Number: (XXX-XXX-XXXX)

Email Address:

Contact Preference: By Phone By Email


Insurance Information


Vision Insurance Name:

Primary Main Member Name:

Primary Main Member Birthdate:

Patient Birthdate:


Appointment Information


Purpose of Visit:

Desired Appointment Date:

Desired Appointment Time:

Comments:





To cancel an existing appointment or if you have an eye care emergency, call us at (408) 247-5102.
 
We accept VSP Vision Service Plan   Vision Service Plan    |  Best of Bay Eye Care

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