Schedule Confirm

Manage Appointments | Manage Details

1. Exam Time & Location 2. Registration/Login 3. Patient Information

4. Review & Submit

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[Change Date & Time]

1:35 PM, Mon, December 4, 2023

[Change Personal Info]

This appointment is for:

Title: First Name: Last Name: Phone Number:

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Birth Date: Relationship:

Address:

City: State: Zip Code:

Account Holder:

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Has this patient had an exam at a Shopko Optical store?

Yes

What type of exam does this patient need?

Eyeglasses Only

Contact Lenses Only

Both

Will you be using Vision Insurance?

Schedule an Eye Exam