Seamless Referrals: Partner With ReFocus Eye Health

As fellow eye care professionals, your patients’ well-being is paramount. At ReFocus Eye Health, we understand the importance of collaboration and comprehensive care. Our interdisciplinary team of specialists, optometrists, and surgeons is dedicated to providing unparalleled expertise across various eye conditions and treatments.

By referring your patients to our Hatboro practice, you entrust them to a cohesive network of experts committed to personalized care and cutting-edge solutions. From complex surgeries to advanced disease management, our approach ensures each patient receives tailored attention. Trust ReFocus Eye Health for exceptional care and a seamless continuum of treatment for your patients’ ocular health.

Please fill out the form below to request a referral. You can also fax your referral requests to 844-512-2422.

Patient Information

First Name *

Middle Name

Last Name *

Date of Birth *

Sex

Female Male

Phone Number *

Alternate Phone Number

Insurance Company

Policy Number

Referring Office Information

Doctor First Name *

Doctor Last Name *

Street Address *

Address Line 2

City *

State *

Zip Code *

Practice Name

Phone Number *

Fax Number

Please send a follow up with appointment info

Fax Email

Appointment Request *

Priority (3-4 days) Non-Urgent (1-4 weeks)

Notes for Appointment (please include diagnosis and reason for visit): *

All information is stored securely and is HIPAA compliant

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