Eye Can See - Appointment Scheduling

Step 1: Reminder

This is the Online Appointment Form of Eye Can See Optical Clinic. This form is to be used by customers/patients to control the number of people entering the clinic and can accommodate them all.

This online form shall also serve as a Digital Logbook for Eye Can See Optical Clinic.

At Eye Can See Optical Clinic, we value your Data Privacy and in compliance with RA 10173 or the Data Privacy Act of 2012, this form will be collecting the following information:

Step 2: Fill-Up Appointment Form

Fill-up Appointment Form

First Name

Middle Initial

Last Name

Age

Gender

Province

City/Municipality

Barangay

Street

Contact Number

Occupation

Email Address

Purpose of Appointment

Select Date from Calendar

Select Time

Available Appointment Slots

Available Fully Booked

Step 3: Review Your Information

Your entered information will appear here for review.

Appointment Confirmed!

Thank you for booking with Eye Can See Optical Clinic.
Your appointment details have been successfully recorded.
A confirmation email or text message will be sent to you shortly.

Please arrive 10–15 minutes before your scheduled time for verification.