Skip to main content

Appointment Request Form

Home » Contact Us » Appointment Request Form

Appointment Request Form

  • Please fill in the form below to setup an appointment.
  • Please provide a reason for your appointment. Details are stored securely and not sent by email.
  • Please let us know when you would prefer to have your appointment. Our hours are listed on our location page.
    Please let us know if you are a new or existing patient.
  • :
  • This field is for validation purposes and should be left unchanged.

Low Vision Patient able to read her newspaper again

Low Vision Patient able to see clear at a distance again with E-Scoops

Low Vision Patient able to see from a distance again

Low Vision Patient able to read for the first time in a long time

Low Vision Video Testimonial

Adjust Text Size Normal Large Extra Large
x

As a service to our community, we continue to see only patients with urgent eye care needs because if we can keep you out of the Primary Care Physician’s office – where sick people are – and out of the Emergency Room – where really sick people are, then we can help keep more families safe.

Therefore, our office will ONLY care for patients with eye emergencies and critical needs, as qualified by our technician and doctor. However, we are able to assist you with several non-urgent needs – please continue reading for full details below.

In the event of an eye emergency, call our office immediately – (734) 525-8170.

You will be connected to Dr. Jacobi. If you reach his voicemail, he requests that you please leave your full name, phone number and a brief reason for your call. He will respond as soon as possible!

For non-urgent needs, please leave a message on our voicemail and your call will be returned within two business days. We appreciate your patience!

We will get through this together! Our hopes and prayers continue to be with you! For more information, click here: https://conta.cc/2xV4JNZ