:: Brint Custom Vision :: Schedule a Free Consultation ::

Consultations are held with one of our experienced surgical counselors at our offices Monday through Friday. As part of our ongoing commitment to quality care, we work hard to ensure that you are seen promptly at your scheduled appointment time. Plan on being at Brint Custom Vision for approximately one hour on the day of your consultation.

If you would like to schedule an appointment, please call us at 504.888.2020, or email the information requested below.

Note: Required fields are indicated with an *

Please reserve a seat for me to attend a complimentary vision correction consultation on:

* Day:

* Time:

* Enter Date (mm/dd/yy):

* Name:

* Telephone Number:

* E-mail Address:

Address:

City:

State:

Zip:

Confirm my appointment by (choose one):

Phone:

E-mail:

Optional Information
I am interested in:
I currently wear (Check as many as apply):
	Soft Contacts	Gas Permeable Contacts
	Glasses	No Correction
I am:
I wear correction: