Please note: This form is for referring doctors and staff only.
If you are a patient, please call our office at 817-442-2020 or fill out our contact form here.
Please complete the form below to refer your patient to our office. Please provide the last visit note, current patient demographics and current medical insurance card to our office. If your patient has a Medical HMO Insurance, they will need an Insurance Referral from their Primary Care Provider to our office. Please advise all contact lens patients, they will need to discontinue wearing contacts for 1 week prior to their vision correction evaluation (i.e.: Cataract, LASIK, PRK, RLE or ICL exams).