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Request an Appointment with Lafayette Ophthalmologist - Dr. Kirk LeBlanc

The first step towards better vision is to schedule an appointment. Please contact our office by phone or complete the appointment request form below. Our scheduling coordinator will contact you to confirm your appointment.

Please do not use this form to cancel or change an existing appointment.


Items in bold are required.
Name:  
Address:
City:
State/Province:
Zip/Postal:
Phone:
Email:
Are you a current patient?
Best time(s) to call?
Preferred day(s) of the week for an appointment?
Preferred time(s) for an appointment?
Please describe the nature of your appointment (e.g., consultation, check-up, etc.):
 
 

Note: Messages sent using this form are not considered private. Please contact our office by telephone if sending highly confidential or private information.

 

Payment Options & Insurance

For your convenience, we accept cash, personal checks, and most major credit cards.

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For exams and surgeries we accept:

Medicare / Private Insurance / Self Pay

To understand your insurance plans, please contact your insurance carrier. Our optical department does not participate with insurance plans. We do not participate with Vision Care/Plans.