MDE
Want to make an Appointment for you, your loved one or for an employee,  for in-office, nursing home, home care or to your Safety Company,  please e-mail to:

Vwilliams@diagnosticeyecare.com    Mail To:
                                                                                                     DIAGNOSTIC EYECARE
                                                                                                     2750 Mt. Moriah Parkway
                                                                                                     Memphis, TN.  38115

                                      

Or you can call direct to our office:                                          Or fill out the form below an click
(901) 766-6742 or 761-3369                                                 Submit
Fax: (901) 766-6743


To make an Appointment in-office for Self, please provide reason for appointment (eyeglasses, contacts, eye disease etc) along with insurance information. If making appointment for self and you are the member, than member I-D, DOB., should be given, so your insurance can be verified before your appointment.

To make an Appointment in-office for a Familymember, than the members information must be given (I-D DOB, address if different) along with the patients infor (name DOB., SS#) and reason for visist.

To make an Appointment for a Nursing Home Visit,please include reason for visit (eyeglasses, eye disease etc). Patients information, location and room number, insurance Medicare, Medicaid, I-D, SSI, etc., along with any sub insurance. You will be contacted from our Mobile Division for scheduling purposes.

To make an Appointment for HomeCare Visit, please include reason for visit (eyeglasses, eye disease etc), address with city & state, along with phone numbers, patients insurance with DOB., and any sub insurance. you will be contacted by our Mobile Division for scheduling purposes.

 To make an Appointment for scheduling at a  Industrial  Plant, please give detailed information from safety manager.

Patient Contact Information:
First name:  * required
Last name:		* required
Email address:		* required
Company:
Mailing address:
Appointment Information:
Requesting Eye Care Visit For:
Best way to contact you:		Email address Home Mailing address Work Mailing address Cell Phone Work Phone Home Phone