Thank you for the trust you put in Alliance Ophthalmology. This information will will be transferred to a staff member who will contact the patient in a timely manner. Alliance Ophthalmology is committed to treating and using protected health information responsibly. In using this information, our office will comply with all state and federal laws pertaining to a patient’s privacy rights, including the Privacy and Security protections provided to the patient by HIPPA.

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.

  • MM slash DD slash YYYY

Alliance Ophthalmology

4501 Heritage Trace Parkway,
Suite 121
Fort Worth, Texas 76244


Our office hours are:
Mon – Thurs :: 8:30am – 5:00pm
Friday :: 8:30am – 12:00pm
Saturday :: By Appointment Only