Appointment Request Form


Satisfaction Survey

Please tell us about your last visit to Appleton Eye Associates.

Service Ratings
Optional Personal Information

Contact Form

If this is an emergency DO NOT contact us via this form. Please call our Newburyport Office immediately at 978-465-8761 or find the nearest emergency room.

We value your opinion and would love to hear your thoughts and feedback on your experiences with Appleton Eye Associates. This information allows us to continually improve the services we offer to our patients.

Submit a Testimonial

Our patients are the backbone of Appleton Eye Associates.

If you would like to share your experiences with others considering joining our family please write a brief testimonial using this form.

We will use your first name and last initial if your testimonial is published.