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Appointment Request Form

Please note doctor’s schedule:

  • The doctor examines patients on Wednesdays and Fridays.
  • The office is open 6 days a week but Dr. Cross gives patient care on Wednesdays and Fridays only.

Ask for an eye exam with Dr. Cross

  • 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. The office is open 6 days a week but Dr. Cross gives patient care on Wednesdays and Fridays only.
    Please let us know if you are a new or existing patient.
  • :
  • TRICARE
    PRIME EAST
    PRIME EAST RETIRED
    SELECT ACTIVE DUTY SPONSOR
    RESERVE ACTIVE DUTY SPONSOR
    DO NOT HAVE (go to next survey)
    We DO NOT take TRICARE FOR LIFE, TRICARE WEST, TRICARE OVERSEAS, TRICARE families off of ACTIVE DUTY ORDERS, JOHNS HOPKINS USFH, MEDICARE, MEDICAID, or VSP. If we don't take your vision plan we will see you out of pocket.
  • OTHER
    EYEMED/ AETNA
    DAVIS VISION
    VBA
    ADVANTICA
    NVA
    SPECTERA
    SUPERIOR VISION COMMERCIAL
    SELF PAY
    N/A I HAVE TRICARE
    We take the following INSURANCES however it is your RESPONSIBILITY to find out if Dr. Cross takes YOUR PLAN by contacting your insurance company. We DO NOT TAKE MEDICARE, MEDICAID, or VSP. If we do not take your vision plan we will see you out of pocket.
  • This field is for validation purposes and should be left unchanged.