Consultation Form

Depending on the patient’s age, medical history, care needs and BMI, the patient may be scheduled at an affiliated hospital instead of our Ambulatory Surgery Center (ASC).

Appointment Request

Co-Management Preferences

Following our evaluation, we will communicate any findings and/or treatment recommendations. If surgery is necessary please indicate below if you'd like to co-manage. Regardless, all patients will be sent back to the referring provider to resume general eye care as appropriate.