Skip to content
2877 Crooks Rd, Suite B, Troy, MI
(248) 822-7003
(248)
822-7008
New Patient
Patient Portal
Pay Online
About Us
Our Doctors
Services
Patient Resources
Book an Appointment
Book an Appointment
Please complete the form and one of our Medical Receptionists will call you to schedule an appointment.
Name
(Required)
Phone
Email
(Required)
Is this appointment for you?
(Required)
Yes
No
Current or Preferred Doctor
(Required)
A. Luisa Di Lorenzo, M.D., FACS
Sue Lim, M.D.
Elizabeth Duvall, M.D.
Insurance
(Required)
Medical
Vision
What does patient wear?
(Required)
Glasses
Contact Lenses
Both
Preferred Appointment Date
(Required)
MM slash DD slash YYYY
Preferred time of day?
(Required)
Morning
Afternoon
Evening
Additional Comments
Name
This field is for validation purposes and should be left unchanged.
2877 Crooks Rd, Troy, MI
(248) 822-7003
About Us
Our Doctors
Services
Patient Resources
Contact Us
Book an Appointment
New Patient
Patient Portal
Pay Online
Skip to content