Missed appointments by patients are a major problem for health care professionals. To combat this issue, some optometrists use a pre-appointing system in which patients are scheduled for an annual exam a year after their initial visit. Prior to that subsequent appointment, clinic staff often try to contact the patient to confirm the appointment. This study examined baseline levels of appointment keeping, analyzed existing processes for pre-appointing patients, and introduced a revised process package to improve appointment keeping at an eye care clinic. This package included training, mailed postcard reminders and two phone call reminders. Results indicate appointment keeping by pre-appointed patients increased over baseline. The intervention was also shown to be cost-beneficial.