SCHEDULING AN APPOINTMENT

We see patients Monday through Saturday. To make an appointment to see one of our doctors please complete the on-line request form. You will then be contacted, usually within 2 business days, with a proposed appointment date and time.

If you prefer not to make an appointment online you may also call our offices at (913) 362-2323.

Patient Information

Please complete the following patient information.
First Name:
Middle Initial:
Last Name:
Date of Birth:
Please provide us with the following contact information. (Please provide a phone number where you can be reached.)
Contact Name:
Email Address:
Phone Number:

Appointment Request

1. Which location would you like to schedule an appointment for?

Fairway Eye Center
3414 Shawnee Mission Parkway
Fairway, KS

Fairway Eye Center North
1528 NE 96th St Suite A
Liberty, MO

Fairway Eye Center Leavenworth
508 Cherokee St
Leavenworth, KS

2. Please choose 2 appointment dates, in order of preference, that you prefer.

First Choice

Second Choice

3. Please select the doctor you would like to visit.

Dr. Bunde Dr. Borden Dr. Henderson No Preference

4. Reason for your visit and/or additional information: