Request an Appointment

Please note that this form is an appointment request only. To schedule an appointment directly with our team, please call 860.289-3375.

Once submitted, this form will be sent to our scheduling department and a member of our team will contact you to schedule your appointment. 

Please select your preferred date, time and location and it will be accomodated based on availability. 

We will contact you to confirm your appointment date and time.
First name
Last name
Phone - -
Email
Your address and date of birth helps us identify you when scheduling the appointment
Date of Birth - - (mm-dd-yyyy)
Address
Address 2
City
State
Zip
 
Appointment Date & Time
Please select three preferred date and times for your appointment which we will be accommodated based on availability.
Please note that appointment times vary by location and exam type.
Date
Date
Date
 
Best Times to Reach You
We’d like to try and accommodate your schedule with a preferred call back time. Please note that call back time requests depend on availability. If we are unable to reach you by the third attempt, please call us back at 860-289-3375.
 
What to Expect
Once you submit this appointment request, it will be assigned to a customer care representative based in our East Hartford Office. They will call you to book your appointment from the following phone number: 860-289-3375. You may save this number as a contact in your phone for future reference. If we missed you, our team will leave a voicemail asking you to call us back at the same number.

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