Appointment Request Form If this is an emergency, do not contact us via email, please use our emergency contact information. Complete the following form: Please fill in the form below to 'request' an appointment. We will contact you to confirm your appointment availabilityName* First Last Date of Birth* Patient Type* New patient Returning patient Please let us know if you are a new or existing patient.LocationSelect>>Easton OfficeCambridge OfficeDoctorSelect>>No PreferenceAlan S. Bishop, O.D.Stanley A. Feinblum, O.D.Alexander Carpenter, O.D.Reason for AppointmentPlease provide a reason for your appointment. Details are stored securely and not sent by email.Preferred Date & Time*Please let us know when you would prefer to have your appointment. Our hours are listed on our location page.Insurance Type & Insurance Member Identification NumberPlease list your type of insurance along with the member identification (ID) number or subscriber number. Phone*Email* CommentsBest Time to be Reached for Confirmation* : Hours Minutes AM PM EmailThis field is for validation purposes and should be left unchanged.