Call 09 520 9689 ' E Book an appointment

Patient Referral

Complete the form below for a fast & efficient referral which we can follow up on immediately.

Patient name:
Address:
Date of Birth:
Home phone:
Work phone:
Mobile phone:
Referred to:
- First Available Booking
- Julia Escardo-Paton
- Joel Yap
- Penny McAllum
- Mark Donaldson
- Andrew Riley
Please review my patient for assessment of:
- Refractive Cataract
- Glaucoma
- Retina
- Cornea
- Ocular Surface
- Squint/Paeds
- Uveitis
- Lids/Lacrimal
- Pterygium
- Neuro-ophth
- Other
Additional info:
Vision (R) 6/ (L) 6/
Appointment made for patient?
- Yes, Date:
- No, Eye Doctors to contact patient.
Referrer Name:
Referrer Email:
Date:
Referrer details:

For personalised eye care, get in touch with one of our specialist surgeons

Eye Doctors are open during Alert Level 3 restrictions for COVID 19

Eye Doctors are open to see you safely during Alert Level 3. We are here ...
Eye Doctors Grand Round Dates 2020

Eye Doctors are pleased to announce the dates of our Grand Rounds for Optometrists in ...
Eye Doctors are open during level 2 restrictions for COVID 19

Eye Doctors are open to see you safely during Level 2. Please contact us as usual if you require an appointment or surgery.