Make An Appointment With Dr. Frazee

Patient Name
Date of Birth (MM/DD/YY)
Current or New Patient
Phone Number (Area Code First)
Email Address
I Need An:	Examination for Eyeglasses Examination for Contact Lenses *IF YOU HAVE AN EYE PROBLEM PLEASE CALL OFFICE IMMEDIATELY (972) 530-8800
When would you like your appointment to be?
Choose the Day of the week
Time
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VISION PLAN INFO
Which Plan Do You Have?
Member's Name
Member's Social Sec. #
Home (Evening) Phone
Work (Daytime) Phone
Member's Date of Birth (MM/DD/YY)
Please provide your Benefit Verification Phone Number (Look on the back of your Insurance Card)
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