Skip to main content

Dry Eye Referral Form

  • Date Format: MM slash DD slash YYYY
  • Date Format: MM slash DD slash YYYY
  • If you are sending this from an optometrist or ophthalmologist's office, please send in a copy of the most recent exam.(must be within one year)
Adjust Text Size Normal Large Extra Large
x

We are open by appointment only. Our current hours are Monday to Friday, 8am – 4pm. Please call our office to schedule an appointment. Read about our safety protocols here.