Appointment Request Form Thank you for choosing Doctors Vision Care. Below is our appointment request form. Please fill out the necessary boxes. Once we receive your request for your appointment, one of our staff members will call, text or email you within 48 hours to offer you an available appointment time. Reason for Appointment*Please provide a reason for your appointment. Details are stored securely and not sent by email.Patient Type* New patient Returning patient Location Preference*BiggarOutlookRosthernSaskatoon-BlairmoreMartensvilleAppointment Date Request MM slash DD slash YYYY Appointment Time RequestNo preferenceMorningAfternoonEveningDoctor PreferenceNo PreferenceDr. Michelle SkoretzDr. Katie LeidlDr. Justine HarrisDr. Jasmine YakubowskiDr. Cora PlummerDr. Kirk EwenName* First Last Birthday* MM slash DD slash YYYY Address* Street Address Address Line 2 City AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Postal Code Phone*Email* How would you like to be contacted?No preferencePhoneEmailTextBest Time to be Reached for Confirmation* : Hours Minutes AM PM CommentsThank you for your request. If you are having an ocular emergency that needs to be seen within 48 hours, please call our office at 306-651-3331. Thank you. PhoneThis field is for validation purposes and should be left unchanged.