Refer a Patient

How to Make a Referral

Eye Care Physician:

• Complete the online referral form here.
• If preferred, download, print and complete the referral form and fax to 404-875-4568.
• Please include a copy of the patient’s latest eye report (from within the last 12 months), if possible.
• CVI will contact your patient to schedule an appointment.

Community Service Provider:

• Complete the online referral form here.
• If preferred, download, print and complete the referral form and fax to 404-875-4568.
• Please include the Authorization to Release Information Form, signed by your client (if possible).
• CVI will contact your client to schedule an appointment.

Thank you for supporting CVI via your referrals! Please contact CVI at 404-875-9011 with any questions.