Provider Referral Form
To refer a patient to Vision & Learning Center, fill out the online form below. If you'd prefer, download our printable referral form and fax us a hard copy.
Send Us a Referral
Fill out the form below and we'll take it from there. Fields marked with an asterisk are required. Prefer paper? The printable form and fax number are just below.
Prefer Paper?
Download the referral form, then fax the completed form and any relevant records to (561) 462-1245. We'll contact the patient directly to schedule an evaluation.
- Fax: (561) 462-1245
- Phone: (561) 462-1245 — we're glad to talk a referral through before you send it.
A Trusted Referral Partner
We work alongside providers across South Florida — Coconut Creek, Boynton Beach, Boca Raton and West Palm Beach — when a patient's difficulty looks like it may be visual rather than purely academic, attentional or neurological.
Pediatricians & Family Doctors
For children with reading struggles, attention concerns, headaches, or a noticeable eye turn.
Occupational, Physical & Vestibular Therapists
When visual-motor, balance, or coordination goals stall and a visual component is suspected.
Neurologists & Concussion Clinics
For post-concussion visual symptoms — double vision, light sensitivity, motion sensitivity, reading fatigue.
Educators & Reading Specialists
When a capable student's reading or output doesn't match their ability despite good instruction.
Speech & ABA Therapists
When visual skills appear to be limiting progress in other therapies.
Ophthalmologists & Optometrists
For co-management of binocular vision conditions and post-surgical strabismus therapy.
Chiropractors refer to us as well, and so do other providers not listed here. If you suspect a visual component in a patient’s difficulty, the referral works the same way whatever your discipline.
After You Send a Referral
We contact the patient
We reach out to the family directly to schedule a comprehensive developmental and binocular vision evaluation — and we keep you posted once your patient books an appointment.
We evaluate
The evaluation looks past 20/20: eye teaming, focusing, tracking and visual processing, alongside eye health and refraction. See what an evaluation covers.
We report back
Reports and treatment plans are sent following the evaluation, so you see exactly what we found and what we recommend.
We co-manage
If vision therapy is recommended, we keep you updated on progress and work alongside your own treatment goals.
In short: we will keep you posted if your patient schedules an appointment, and follow up with a report of our findings. Questions about whether a particular patient is a good fit? Call us at (561) 462-1245 — we're glad to talk it through.
Not Sure If It's a Fit?
These pages are written for colleagues and families deciding whether an evaluation is worth the visit:
- Symptom checklist — a short questionnaire families can complete before the referral.
- Signs and symptoms by complaint — reading trouble, headaches, double vision, dizziness, poor handwriting.
- Common referral diagnoses: convergence insufficiency, ocular motor dysfunction, accommodative dysfunction, amblyopia and strabismus, post-concussion vision.
- What a developmental evaluation includes and how vision therapy works.
- Resources for professionals, continuing education, and our referral network.
- Special-needs eye care — how we adapt an exam for patients with autism, Down syndrome, cerebral palsy or developmental delays.
- Patient outcomes and why 20/20 vision doesn't rule out a visual problem.
Everything written for colleagues lives on the provider hub — including resources by specialty, CE courses, and how to request a speaker, a course or a vision screening for your practice, school or organization.
Referring a family to us? We publish a page for each referral source, so parents arrive knowing why they were sent — who referred you covers eye doctors, pediatricians, OTs, PTs, psychologists and teachers.
Have a Patient in Mind?
Send the referral and we'll handle the scheduling, the evaluation and the report back to you.