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Home » Contact Us » Appointment Request Form

Appointment Request Form

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

Complete the following form:

  • Please fill in the form below to setup an appointment.
  • Please provide a reason for your appointment. Details are stored securely and not sent by email.
  • Please let us know when you would prefer to have your appointment. Our hours are listed on our location page.
    Please let us know if you are a new or existing patient.
  • :
  • This field is for validation purposes and should be left unchanged.

As required under Michigan Executive Order 2020-21, our office will be closed through April 13, 2020.  If you have ordered contact lenses or eyeglasses, we will make arrangements with you to have your order sent directly to your residence.  If you have less than a two-month supply of contact lenses, please contact us and we will be happy to place an order for you. 

If you have any questions about an order, or are experiencing an eye care emergency, please call our office or text message us at 734-414-1892 or email us at reception@progressivefamilyeyecare.com.  

If you would like to schedule an appointment for a date after April 14, 2020, please contact us and leave a message and we will reply to schedule the appointment.  Together we will weather this storm.  Thank you for your continued support and stay safe, https://www.michigan.gov/whitmer/0,9309,7-387-90499_90705-522626--,00.html