Appointment Request Form

Vision Insurance/ Insurance (if any):
Insurance Number:
I would like an appointment with:

Please select up to 3 appointment dates / times.
If you can't find a convenient appointment time, please call our office

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Please Note: The requested appointment time(s) may no longer be available. We will contact you to confirm your actual appointment date and time.

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  • Whittington Eye Care Associates

    Jeff Whittington, O.D.
    Sandra Whittington, O.D.
    Kent Hall, O.D.
    Jennifer Stevens, O.D.

    3840 Pennsylvania Avenue
    Charleston, WV 25302

    304-342-0660