Patient Referrals

Eye doctors can refer to us in one of two ways:

• Option 1. Download this referral form, then email the completed form to [email protected] or fax it to 603-224-4378.
• Option 2. If your office uses RevolutionEHR, there is an Electronic Medical Record (EMR) Template add-on that you can install for free – this will streamline the paperwork we need to begin working with your patient.
  • Not a RevolutionEHR customer? Let us know so we can start working with your EMR provider to make the process better for all of us!