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Schedule AN Appointmemt

Currently we have 3 doctors at Shoreline Optometry:
All doctors are currently accepting new patients
Dr. Seger works Monday and Wednesday afternoons
Dr. Webb works Monday - Friday mornings, and Tuesday and Thursday afternoons
Dr. Nguyen works Monday - Friday mornings, and Monday and Wednesday afternoons

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Name *

First

Last

Phone Number *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Gender *

Male Female

Email *

Date of Birth (MM-DD-YYYY) *

Are you a new patient to our office? *

Yes No

Contact By: *

E-mail Phone

Which Doctor do you see? *

What is the reason for the appointment? *

What days work best? *

Monday Tuesday Wednesday Thursday Friday

Please let us know which days work best for you.

Preferred Times *

Please enter up to three times of day that would work well for you (i.e. "First thing in the morning" or "Wednesday afternoons" or "Around 10am").

VSP insurance information (if you do not have insurance, enter none or private pay)

Primary member's full name *

First

Last

Primary member's date of birth (MM-DD-YYYY) *

Last 4 digits of member's SSN and/or Employee ID# for Google employees *

Comments *

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Contact Us
419 N. Shoreline Blvd
Mountain View, CA 94043
Phone: 650-967-5789
E-mail: contact@shorelineoptometry.com

Office Hours
Mon 8:00 am - 12:15 pm, 2:00 pm - 5:00 pm
Tue 8:00 am - 12:15 pm, 2:00 pm - 5:00 pm
Wed 8:00 am - 12:15 pm, 2:00 pm - 5:00 pm
Thu 8:00 am - 12:15 pm, 2:00 pm - 5:00 pm
Fri 8:00 am - 1:00 pm
Sat & Sun: Not Open

Notice of Privacy Practices
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Home
About
Patient Forms
Insurance Plans
Schedule Appointment
News & Articles
- Practice News
- Eye Care Articles
Optical Boutique
- Lens Options