Ready to Schedule Your Appointment?
Simply fill out the form below, and one of our team members will contact you as soon as possible to finalize the details and get your appointment scheduled at The Solution Center, located at 937 Polaris Woods Blvd in Westerville, OH 43082.
Patient's Name
*
First Name
Last Name
Parent/Guardian's Name
First Name
Last Name
What type of appointment did you want to schedule?
*
Eye exam-existing patient
Eye exam-new patient (welcome!)
Other
Do you have a preferred doctor, date, or time that you would like us to look for?
How would you like us to contact you to schedule this appointment?
Text
Email
Phone call
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Patient's birthday
*
-
Month
-
Day
Year
Date
Email
example@example.com
Phone Number
*
If you would selected "Text Me," please provide a cell phone number that can receive text messages.
Insurance information
*
If you have a vision insurance, please list the name and date of birth of the primary insurance cardholder (usually the parent or guardian who provides the insurance), so we can ensure everything is ready for your appointment.
Submit
Should be Empty: