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Appointment Request Form

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

To request your next appointment complete the form below.   

PATIENT INFORMATION MUST BE COMPLETED BEFORE TIME OF APPOINTMENT.  CLINK ON LINK BELOW FOR REQUIRED PATIENT INFORMATION.

 Patient Registration

PLEASE, PRINT ALL FORMS AND BRING THEM WITH YOU AT THE TIME OF APPOINTMENT.  THESE WILL BE FOUND IN THE PATIENT INFORMATION LINK:  BEFORE CHECKING (I HAVE READ THE PRIVACY STATEMENT): GO TO (CLICK HERE) TO REVIEW AND PRINT FORMS.

 

 

  • 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.

Call for an Appointment, We are open!

We are making special arrangements with the current public health concerns. When you call Texas State Optical Pearland, we will space your appointment time to be mindful of social distancing and your personal comfort.

Texas State Optical Pearland is here for your vision care. We are aware of your concerns and are taking extra precautionary action for your protection and safety. We carefully sanitize all surfaces, including equipment, frames and supplies, frame boards, desks, and keyboards.

When you schedule your eye exam appointment, you can have the extra confidence that you will be safe and comfortable at Texas State Optical.

Make an Appointment with:


Dr. Hilliard



Dr. Walton