Appointment Request Form

We are currently seeing patients via telehealth only. If you have any questions, please call us to discuss.

Please fill in the form below to setup an appointment.
Preferred Office*
- College Park
- Glenn Dale
- Telehealth
Name*
First Last
Date Of Birth*
Phone*
Email*
Reason for Appointment*
Please provide a reason for your appointment. Details are stored securely and not sent by email.
Patient Type*
- New patient
- Returning patient
Please let us know if you are a new or existing patient.
Comments
Phone
This field is for validation purposes and should be left unchanged.

Dear Valued Patient,

At Vision MD Eye Doctors, the health and safety of our patients and employees is our top concern.

Our office has a long-standing practice of disinfecting all areas of our office throughout the day, and all clinic areas are disinfected prior to every patient seen.

As always during the peak of flu season, and with the growing concerns around the Coronavirus, we have taken extra measures to increase frequent cleaning and have provided additional training and precautions to our staff to help keep their health and yours safe.

As a reminder, if you have fallen ill, have traveled abroad, or had close contact with someone who has traveled abroad within the past 14 days and are due to be seen for an appointment, please let our office know. We will be happy to change your appointment to ensure the safety of our patients and staff.

Feel free to contact us with any questions. Thank you.

Vision MD Eye Doctors Team

Appointment Request Form

Vision MD Eye Doctors – Glenn Dale

Vision MD Eye Doctors – College Park