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Contact Information

Suburban Eye Care

Phone: 734-525-8170
Fax: 734-525-0726
Email: eyesupport@suburbaneyecare.com
(Do not send personal health information by email.)

Contact our eye care staff to book or request an appointment by filling out one of the forms below. We look forward to hearing from you.

We believe that providing quality eye care to our patients is a two-way street, so please let us know where we can make improvements or what kind of services you would like to see in the future. Your feedback is important to us.

Specific Requests

To request information or billing questions

Your Name*
First Last
Subject*
Message
Should we reply?*
- Yes, Email Me
- Yes, Call Me
- No
Email*

Please provide an email address so we can contact you.
Phone*
Please provide a telephone number, with area code, so we can contact you.
Comments
This field is for validation purposes and should be left unchanged.

To Schedule An Appointment

Please fill in the form below to setup an appointment.
Reason for Appointment
Please provide a reason for your appointment. Details are stored securely and not sent by email.
Preferred Date & Times*
Please let us know when you would prefer to have your appointment. Our hours are listed on our location page.
Patient Type*
- New patient
- Returning patient
Please let us know if you are a new or existing patient.
Name*
First Last
Phone*
Email*
Best Time to be Reached for Confirmation*

: Hours

Minutes
Comments
Name
This field is for validation purposes and should be left unchanged.

To reorder or check on status of an existing prescription refill, contact lens, solution or eye drop order

Name*
Please provide your first and last name.
First Last
Email Address*
Phone Number*
Preferred Method of Communication*
Reason
What is the reason for this form today?
Supply Needed*
Delivery Option*
*Delivery is free for most 12 month supplies.
Your request will not be filled until reviewed by a technician and confirmed by phone or email, thank you.
Additional Notes*

To order or check on the status of an existing eyewear order

Your Name*
First Last
I would like to
Message
Should we reply?*
- Yes, Email Me
- Yes, Call Me
- No
Email*

Please provide an email address so we can contact you.
Phone*
Please provide a telephone number, with area code, so we can contact you.
Email
This field is for validation purposes and should be left unchanged.

To request an Expert Talk at your next event or staff meeting

Your Name*
First Last
Message
Should we reply?*
- Yes, Email Me
- Yes, Call Me
- No
Email*

Please provide an email address so we can contact you.
Phone*
Please provide a telephone number, with area code, so we can contact you.
Phone
This field is for validation purposes and should be left unchanged.

To Submit your resume for an exciting career in eye care

Your Name*
First Last
Position*
Email*

Please provide an email address so we can contact you.
Phone*
Please provide a telephone number, with area code, so we can contact you.
Upload your resume*
Max. file size: 31 MB.
Comments
This field is for validation purposes and should be left unchanged.

General Inquiries

We'd like to hear from you!

If this is an emergency, do not contact us via email, please use our emergency contact information.
Your Name*
First Last
Subject*
Message
Should we reply?*
- Yes, Email Me
- Yes, Call Me
- No
Email*

Please provide an email address so we can contact you.
Phone*
Please provide a telephone number, with area code, so we can contact you.
Comments
This field is for validation purposes and should be left unchanged.

Appointment Request Form
Contact Form
Medical Record Release Request
Order Contact Lenses

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Suburban Eye Care - Located at 32415 Five Mile Rd, Livonia, MI 48154 Phone: (734) 525-8170 https://www.suburbaneyecare.com

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