Skip to main content
Book Exam
Call Us!
Home » Contact Us » Appointment Request Form

Appointment Request Form

Eyes are the windows to your overall health, and comprehensive eye care goes beyond a prescription for glasses or contact lenses. At Jeanine Graves OD, we take pride in providing the best eye care, we eye clinic serves the Fair Lawn and Paterson, NJ area. Our dedicated staff take the time to get to know you, your eye care history, and your vision needs. Our optometrist, Dr. Jeanine Graves, and her staff provide the expert care, advice, options, and follow up you need whether you are a new patient or an existing one. 

If this is an emergency, do not contact us via email, please use our emergency contact information.

To request your next appointment, please complete the form below and let us know the most convenient time and date for you.  Please don't forget to include accurate contact details so we can follow up with you to finalize your request.

  • Please fill in the form below to setup an appointment.
  • Please provide a reason for your appointment. Details are stored securely and not sent by email.
  • Please let us know when you would prefer to have your appointment. Our hours are listed on our location page.
    Please let us know if you are a new or existing patient.
  • :
  • This field is for validation purposes and should be left unchanged.