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FIND A DOCTOR

Welcome! To search for an eye doctor in your area, submit your free referral request form below. This is NOT a membership or subscriber form. We do NOT sell, lease, or otherwise market your personal data. See Privacy Policy. To make an appointment or ask questions, contact the selected doctor's office directly.
Please enter your zip code.
If you don't know it, then enter your city and state.
REQUIRED FOR YOUR FREE EYE CARE REFERRAL:
First Name:  Last Name:
Full address OR City, State and ZIP:* (Example:1234 Main St., Chicago, IL OR Chicago, IL 60601)
Country: Search Radius:
Email: (Your referral will be emailed to you.)
* If you provide your complete address, a map with driving directions will be displayed.

OPTIONAL:

Information below can be voluntarily added. This helps us to better serve the public. Thank you.

Requesting referral for:

Telephone:

This person has already been diagnosed with (check one or more):

Amblyopia (lazy eye)
Astigmatism
A.D.D. or AD/HD
Autism spectrum disorder
Cataract
Color vision problem
Convergence insufficiency
Depth perception Problem		 Developmental delays
Double vision
Dyslexia
Esotropia (inward eye turn)
Exotropia (outward turn)
Eye teaming problems
Eye tracking problems
Hyperopia (farsightedness)
 Hyperphoria (vertical)
Myopia (nearsightedness)
Nystagmus
Poor depth perception
Presbyopia (over 40)
Reading problems
Strabismus
Other

Additional comments on visual history or condition:






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