Appointment Request Form

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If this is an emergency, do not contact us via email, please use our emergency contact information.

Complete the following form:

Location
Required
Doctor
Required
Reason for Appointment Appointment requests are sent to your practitioner using regular email so please do not enter confidential information.
Preferred Dates & Times
Required

Check our office hours
First Name
Required
Last Name
Required
Telephone
Required
Email
Best Time to be Reached for Confirmation
Required
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Locate Us

Port Moody Optometry Clinic

260 - 221 Ioco Road
Port Moody BC V3H 4H2
Phone: (604) 469-8428
Fax: (604) 461-6352
Emergency Contact:

In case of after-hour emergency, please go to the emergency room of the nearest hospital.