About UsLocationsContact UsSite MapHome
Wallace Eye Center
Eye HealthTechnologyOpticalEventsWhy Choose Us?DoctorsPatient Forms
   CONTACT US
::>> Appointments
::>> Contact Form
::>> Locations
::>> Events Reservation Form
:: SITE LAST UPDATED: 9.30.2010  

Contact Us for More Information

We are here to answer your questions and ease your concerns. Feel free to complete the form below. Thanks for your interest, and we look forward to improving your vision.

 This form just takes a moment to use.

Name: (Required)
Address:
City:
State:
Zip:
Daytime Phone:
Evening Phone:
Email: (Required)
Age: Male Female
   
Are you interested in
(check all that apply):
Having information mailed to your home address
Other
   

What should we know about you?

This is not a secure contact form. Please do not include sensitive medical information in your appointment request that you would not normally feel comfortable sending over email.

 

 

Links
·  We have links to several other sites that may help you
Appointments
· Schedule a consultation with our doctors. Tell us when you would like to visit.
Email News Updates
Sign up for email news updates. Enter your email address and hit enter.
 

VISIT US AT: 211 McAuley Court, Hot Springs, AR, 71913
PH: 501-624-0609 | 1-800-794-5600 | FAX: 501-624-6191
EMAIL: wallaceappt@cablelynx.com

Eye Health | Technology | Optical | Events | Why Choose Us? | Doctors | Patient Forms
Mojo Interactive Programming, Design and Hosting by Mojo Interactive, © 2002-2010.
Content © 2002-2010 Patient Education Concepts, Inc. Licensed Users Only