Due to Covid 19, ALL visits are by appointment only

Newcastle Eye Care

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Newcastle Eye Care

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Keeping You SAFE!
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Home
About Us
Glasses
Appointments
Keeping You SAFE!

Appointment Request

Dr. Lee - Monday, Tuesday, Wednesday / Dr. Teo - Thursday, Friday

Patient First and Last Name*

Email*

Home Phone #*

Cell Phone #

Preferred method of contact (email/ phone call/ text)*

Date of Birth (Month/ Day/ Year)*

Primary Reason (eye exam, adjustment, repair etc)*

Would you also like a quote for eyeglasses? (Y/N)

1st Choice: Indicate preferred Day of the Week and Time Block (morning/ afternoon/ evening)*

2nd Choice: Indicate preferred Day of the Week and Time Block (morning/ afternoon/ evening)*

Hours

Today

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