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Ophthalmology Referral


Ophthalmology Referral

Referring Provider Information:

Patient Information:

Reason fo Referral
Select the patients pefered locaton(s)
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If a patient needs surgery/procedure they will need specific post operative care. All patients will be sent back to their referring provider for general eye care. If surgery/procedure is scheduled post ops should be:

Thank you for your referral.

Our scheduling team will contact your patient within 1-2 business days.

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