Appointment Request

You have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost

Under the law, health care providers need to give patients who do not have insurance or who are not using insurance an estimate of the bill for medical items and services.

  • You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.
  • If you have scheduled your appointment 10 or more days in advance, your health care provider will prepare a Good Faith Estimate at least three business days prior to your scheduled medical service. If you have scheduled your appointment between 3-9 days in advance, your health care provider will prepare a Good Faith Estimate at least one business day prior to your scheduled visit. If your appointment is scheduled less than 3 days in advance, your healthcare provider is not required to prepare a Good Faith Estimate. You can also ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service.
  • If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute your bill.
  • Make sure to save a copy or picture of your Good Faith Estimate.

For more questions or information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or all 800-633-4227.


The first step towards better vision is to schedule an appointment. Please contact our office by phone or complete the appointment request form below. Our scheduling coordinator will contact you to confirm your appointment

Please do not use this form to cancel or change an existing appointment.

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