SACS-Appointments

OptiHealth Clinic
Appointment Form

San Antonio Christian School
1722 E 8th Street, Ontario, CA 91764

SUNDAYS, 10:00 AM - 4:00 PM

* Indicates required field

Name: *

First

Last

If for a Couple Appointment, partner's Name: *

First

Last

Phone #: *

Email: *

Preferred contact method(s) for scheduling your appointment: *

Phone Text Email

IF by PHONE, best day(s) to be called: *

Monday Tuesday Wednesday Thursday

IF by PHONE, best time range(s) on the day(s) indicated above to be called: *

9:00 - 11:00 am 1:00 - 3:00 pm 7:00 - 8:00 pm

Comment or Question (optional): *

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