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Appointment Request Form

Basic form for clients to request an appointment with the practice.
  • 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.

Hello from Dr. Jurgensen & Associates

For the safety of our patients and staff, we will be postponing all non-emergency routine exams.

Our office will be limiting our hours during the next few weeks, but we will be here so you are able to pick up glasses and contact lenses, assist you in ordering contact lenses, and answer any questions you may have.

Thank you for your patience during this difficult time.

Our office hours for the next few weeks will be:

Monday: closed

Tuesday: 10 am-4 pm

Wednesday: closed

Thursday: 10 am-4 pm

Friday: closed

Saturday: 9 am-12 pm

We appreciate your support during this time.