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 form, one of our staff members will call you within 48 hours to confirm the availability of the appointment. Reason for Appointment*Please provide a reason for your appointment. Details are stored securely and not sent by email.Patient Type*New patientReturning patientPlease let us know if you are a new or existing patient.Location Preference*Blairmore SaskatoonMartensvilleBiggarRosthernOutlookAppointment Date Request Date Format: MM slash DD slash YYYY Appointment Time Request9:00am9:30 am10:00am10:30am11:00am2:00pm2:30pm3:00pm3:30pm4:00pmDoctor PreferenceNo PreferenceDr. Michelle SkoretzDr. Katie LeidlDr. Justine HarrisDr. Kirk EwenName* First Last Birthday* Date Format: DD slash MM slash YYYY Address* Street Address Address Line 2 City AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Postal Code Phone*Email* Best Time to be Reached for Confirmation* : HH MM 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. CommentsThis field is for validation purposes and should be left unchanged.