Referring Provider Form For Optometrists

Dear Referring Provider,

Family Eye wellness strives to make it easy and hassle-free to refer patients. You can use the online referral intake form below to make referrals.

​​​​​​​We take referrals for:

• Functional/binocular vision evaluations
• Visual information processing testing
• Concussion-related vision problems
• Pediatric and infant eye examinations
• Special needs eye examinations
• Myopia control management
• Strabismus and Amblyopia management
• Light-Sensitive Migraine relief

When you refer a patient to Family Eye Wellness, we will send you a report to assure continuity of care. We look forward to collaborating with you in the continued care of our mutual patient’s vision care needs.