1041 NE Sam Walton Lane, Lee Summit, Missouri 64086

What is the reason for this visit?

Please choose one

To book an appointment,
please select a provider.

Please select a date and time

All fields are required

Please enter your personal information

All fields are required

Additional Notes

All fields are required

Are you a new contact lens wearer?

Please Enter your Insurance Information

Avesis, Davis Vision, Eyemed, Spectera etc

Enter your medical insurance plan
Enter your vision insurance if any

Review and Submit

Please review then click submit.

  • 1. Personal Details
    • :
    • :
    • :
    • :
    • :
  • 2. Appointment details
    • :
    • :
    • :
    • :