Doctor Referrals

Envision Eye Care Dry Eye Referral Instructions

At Envision Eye Care, we are dedicated to providing the highest quality care for patients experiencing dry eye symptoms and related conditions.
If you would like to refer a patient for evaluation or treatment of dry eye, please complete the referral form below. Be sure to include the patient’s preferred date and time for their appointment.

Please note that our team will reach out to the patient directly to confirm their appointment or to offer an alternative date if needed. If you prefer, you are also welcome to call our office to request an appointment on the patient’s behalf. Thank you for trusting us with your patients’ dry eye care needs. We look forward to working together to provide the best possible outcomes.

Referring Provider Details

​​​​​​​Patient Contact Information

​​​​​​​Patient Insurance

​​​​​​​Appointment Preferences

Additional Notes

admin Comprehensive Eye Exam 9:00 am - 5:30 pm 9:00 am - 5:30 pm 9:00 am - 5:30 pm 9:00 am - 5:30 pm 8:00 am - 12:00 pm Closed optometrist # #