Appointment Request Form Call a Location Request an Appointment NOTE: If you are a new patient, please also fill out the New Patient Information Form here. Request An Appointment "*" indicates required fields LinkedInThis field is for validation purposes and should be left unchanged.First Name*Last Name*Phone*Email* Patient Type*New PatientReturning PatientAppointment InformationPlease provide your appointment preferences below. Please note, your appointment is not finalized until a member of our team has reached out to confirm your appointment details directly. Choose a Location*ClintonLee's SummitSedaliaWarrensburgBelton (Innovative Vision Care)Type of ExamRoutine Vision ExamContact Lens ExamMedical Emergency / Follow UpPreferred Doctor*No PreferenceDr. Jason LakeDr. Susan LakeDr. Brett LiesemeyerDr. Kyle JohnsonDr. Jill McNaughtonDr. David OrsonDr. Andrew YeagerDr. Katelyn HardyDr. John DrenonDr. David BaldwinDr. Aaron LawDr. John GelvinDr. Kelsey StarmanAppointment Time*No PreferenceMorning AppointmentAfternoon AppointmentEvening AppointmentAppointment Date* MM slash DD slash YYYY Insurance PlanAdditional CommentsQuestions & CommentsNo Show Appointments & Late Cancellations: Appointments cancelled less than 24 hours in advance and no-show appointments will be subject to a $50 fee; this fee will not be covered by your insurance company. Testimonials
