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Dr. Vincent Gagliardi and Associates

Optometrists

Home » Contact Us » Appointment Request Form

Appointment Request Form

If you prefer to create a profile on our online portal and schedule an appointment online with Dr. Jordyn Fregonese, click on the link below, if you do not see a suitable date available, please use our form as we may have dates available with our other associates.

Schedule Online Appointment

  • 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.

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