Printable Referral Resources

Optometrists

Handouts for optometrists to print and give to patients and families when you refer them to Vision & Learning Center.

Handouts

Print, Share or Email

A referral lands better when the family knows why they are being sent and what happens next. These handouts explain it in plain language, so the conversation you started in your office carries on at home. Print as many as you like, or email the PDF straight to a family.

  • Your eye doctor recommends a binocular vision evaluation

    From the eye doctor: why healthy eyes and the right prescription can still leave an eye-teaming problem, with a check-list and a tear-off co-management referral slip.

    PDF · 1 page

  • What to expect at your evaluation

    A one-page walk through the visit for the family: booking and forms, the evaluation itself, results the same day, the written report, what to bring and how payment works.

    PDF · 1 page

For Your Office

Tools for the Doctor and the Front Desk

These are for your own team rather than for patients: how to refer, what to look for, and what you get back from us.

  • Front-desk guide to referring

    For the person who sends your referrals: who the doctor may send, what to send us, three ways to refer and what happens next, on one page.

    PDF · 1 page

  • Screening kit card

    For the exam room: a binocular vision check in about three minutes, with how to run each test, when to refer, what to say to the patient and what happens next.

    PDF · 2 pages

  • Screening form

    For the exam room: the near-work symptom survey (CISS) on one side and a results sheet for the kit findings on the other. Fax it to us as the referral.

    PDF · 2 pages

  • Exam-room card: 3 signs to refer

    For the exam room: three signs worth referring for even when the patient passed the eye chart, with quick in-office flags.

    PDF · 1 page

  • What you'll get back: a sample report

    For your office: a one-page sample of the written report we send after an evaluation, with findings, the recommended plan and what to expect next.

    PDF · 1 page

  • When patients ask "Is it covered?"

    For your front desk: a half-page card with the answer on insurance, reimbursement paperwork, HSA, FSA, CareCredit, payment plans and FES-UA scholarships.

    PDF · 1 page

Next Step

Sending the Referral

Give the family a handout, then send us the referral. You can use the online form or fax our printable referral form, and we report back to you after the evaluation. Families can also book directly. Questions about a particular patient? Call us at (561) 462-1245.

Have a Patient in Mind?

Send them our way and we’ll evaluate, treat what we can, and report back to you.