Appointment Request

Appointment Request

Appointment Request

Appointment Request Form


Use this form to request an appointment with us. While we will do our best to accommodate your requested day and time, please note, your appointment is not fully booked until you get a confirmation from us!

​​​​​​​Submit the following information to request an appointment

Your Name

Your Email *

Your Phone *

Select Date *

Preffered Time

Your Message

Please do not submit any Protected Health Information (PHI).
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Contact Info

City Eyes Optometry Center
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Address: 4454 Van Nuys Bl. Suite C Sherman Oaks, CA 91403
Get Directions
Phone: (818) 960-1300
Fax: (818) 981-9702