Make an Appointment at Tang Center
DUE TO THE HOLIDAY CLOSURE WE WILL NOT RESPOND TO YOUR EMAIL APPOINTMENT REQUEST UNTIL WE RETURN ON JANUARY 5TH. For emergencies call the clinic directly during working hours or the main clinic at (510)642-2020 for after hours emergency care.

APPOINTMENT REQUEST FORM Please provide the following information.
Name
Phone Number
E-mail
Date of Birth
Do you have insurance?	Yes No
If yes, who is your insurance carrier?	Student Health Insurance Plan (SHIP) Vision Service Plan (VSP) Medical Eye Services (MES) Medicare/Medical Other
Have you visited us before?	Yes No
Do you wear contact lenses or would you like to be fitted for contact lenses?	Yes No
What day of the week and what time of day would you like your appointment? - pick one or more days - indicate time for each   day selected	Any Day Monday Tuesday Wednesday Thursday Friday Morning Morning Morning Morning Morning Morning Afternoon Afternoon Afternoon Afternoon Afternoon Afternoon Any Time Any Time Any Time Any Time Any Time Any Time
Comments
You will receive a confirmation within 24 hours (Monday-Thursday).