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 (512) 452-5735
In the Capital Plaza Shopping Center in Austin

Our Location

5501B N Interstate 35
Austin, TX 78723-2430

CARING FOR
THE EYES OF TEXAS

Home » Find Us » Appointment Request Form

Appointment Request Form

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 ADD NAME OF INSURANCE, PRIMARY CARD HOLDERS NAME, DATE OF BIRTH AND ID # IN THE COMMENTS SECTION

  • 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.

Welcome to Texas State Optical Capital

 
Appointment Form

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