Physician Referral

Refer a Patient

Submit a referral for your patient. Our office will coordinate scheduling and keep you informed throughout their care.

Physician Referral Form

We'll contact the patient within 1-2 business days

Referring Physician


Patient Information

Basic contact information only. Do not include medical records or protected health information.


Referral Details

This form is for basic referral coordination only. Please do not include protected health information (PHI), medical records, or clinical imaging. Records can be sent via fax or secure transfer after the referral is initiated.

Prefer to Call?

For urgent referrals or physician-to-physician consultation, call us directly.

(860) 826-4460

After You Refer

1

We contact the patient to schedule an appointment

2

Patient is seen for evaluation and consultation

3

You receive a detailed consultation report

4

Ongoing communication for co-managed care

Common Referral Reasons

Fuchs' DystrophyKeratoconusDMEK/DSAEKEVO ICLComplex CataractIris RepairCorneal ScarPterygium