Please call (713)  652-9898 if this is an emergency! Email is only checked during business hours

Dr. Ouida Middleton O.D. sees patients at the following times: Monday Morning                Monday Afternoon Wednesday Morning                Wednesday Afternoon Thursday Morning                Thursday Afternoon Friday Morning                Friday Afternoon

Select the time most convenient for you Monday Morning Monday Afternoon Wednesday Morning Wednesday Afternoon Thursday Afternoon Friday Morning

First Choice Day and Time

Second Choice Day and Time

Select the time most convenient for you Monday Morning Monday Afternoon Wednesday Morning Wednesday Afternoon Thursday Afternoon Friday Morning

How would you like for this appointment to be confirmed?

Email Phone

Patient Information:

First Name

Last Name

Address

Your email address:

Telephone

Month January February March April May June July August September October November December

Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31

Date of Birth

19

Select your Insurance Carrier Medicare Medicaid VSP Superior Vision

Insurance Company:

New Patient:

I am a:

Existing Patient

Comments/Special Requests:

Please use this form to request the most convenient date and time for you.  Our staff will determine the closest available date and time for this request and give you a response via the method you selected in the first part of this form

Please note that this on-line appointment request form is unencrypted and unsecured.  If you have additional concerns about your privacy and would prefer not to continue, contact our office to schedule an appointment at (713) 652-9898.

Wooten Vision Care

Appointment Request Form