Please complete as best as you are able. Once you submit this form for a regular or routine eye exam or hearing exam, our appointment staff will contact you to set up your appointment. (If you have an urgent medical problem, please call the office at 706-323-3491.)
West Georgia Eye Care Center now accepts certain VSP, EyeMed and BlueView vision plans for routine eye exams in addition to most medical insurance plans including TRICARE for exams involving a medical diagnosis. Excludes TSYS Eyemed at this time.
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Please tell us what type(s) of service you are requesting for this appointment. (Check all that apply) *
 
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Once you have completed the form please click Submit. Our appointment team will call you to finalize your appointment.