Please *DO NOT* use this method to communicate confidential patient information. The purpose of this form is to request or communicate *GENERAL INFORMATION*. If you wish to communicate with your doctor, please access your account through our secure patient portal or contact our office at 334-271-3804 and ask to leave a message for the coordinator working with your physician. This process ensures your request will be managed promptly and efficiently.

Contact our patient coordinators at 1-800-763-EYES.

(334) 271-3804
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