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Referring Patients For Appointments

How To Refer A Patient To Our Office

(To be seen by one of our physicians)




Please specify if the patient requires a medical eye exam or an annual routine eye exam.

1.  You may fax a referral request form, accompanied by all relevant documentation, to our office at (407) 891-8211 and we will place the patient in our referral queue to call and schedule their appointment.

2. You may call our offices (St. Cloud: 407-891-2010 Kissimmee: 407-530-5977), and schedule an appointment for your referral patient over the phone with one of our friendly staff members.  We will still require a referral request form accompanied by all relevant documentation for the patient.  Without this important information we will be unable to accommodate the patient on the day of their appointment.


What Is Relevant Documentation?

In order for patients to be seen in our office, regardless of the type of appointment, we will require the following information:

  1. Patient Demographics – This must include, Last Name, First Name, Date of Birth, Gender, Phone Number, and Address.
  2. Patient Insurance Information – This must include name of Insurance(s) as well as Member ID #.
  3. Reason For Referral – Either a written explanation or an ICD-10 diagnosis code.
  4. Most Recent Clinical Notes/Test Results – Please send the last clinical note including history, physical, MRI, CT, x-ray results, etc.
  5. Signed Medical Records Release Form – Referred patients need to sign this request and fax it to us so that we can obtain all relevant medical records from all treating physicians.

If the patient you are referring has an HMO insurance we will require a referral with an authorization number and max number of visits specified!  Without this information the patient will not be seen and their appointment will be canceled.