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OPTOMETRY VISION THERAPY REFERRAL/CONSULTATION FOR MTO: Dr. Michael L. Serrano, O.D., P.C. New Vision Eye Care and Rehabilitation Services 3128 Claremont Road NE Atlanta, GA 30329 Phone number (404)

How to fill out optometric vision formrapy referral

How to fill out optometric vision formrapy referral

1. Obtain the optometric vision formrapy referral form from the referring optometrist.
2. Fill out the patient's personal information including name, address, date of birth, and contact information.
3. Provide details about the patient's medical history and any relevant eye conditions.
4. Clearly state the reason for the referral and any specific concerns or areas of focus.
5. Sign and date the form before returning it to the referring optometrist.

Who needs optometric vision formrapy referral?

1. Individuals who have been diagnosed with vision-related issues and require specialized treatment or therapy.
2. Patients whose referring optometrist believes would benefit from additional assessment or intervention by a vision therapy specialist.

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What is optometric vision formrapy referral?

Optometric vision therapy referral is a process where an optometrist refers a patient to a specialized vision therapy program to address specific visual issues and enhance visual function.

Who is required to file optometric vision formrapy referral?

Optometrists who identify the need for vision therapy in their patients are required to file an optometric vision therapy referral.

How to fill out optometric vision formrapy referral?

To fill out an optometric vision therapy referral, you must provide patient information, details of the diagnosis, recommended therapy, and any relevant clinical findings.

What is the purpose of optometric vision formrapy referral?

The purpose of optometric vision therapy referral is to ensure that patients receive the appropriate vision therapy services needed to improve their visual abilities and address specific vision problems.

What information must be reported on optometric vision formrapy referral?

The referral must report patient demographics, clinical assessment findings, specific diagnoses, therapy recommendations, and any immediate needs for intervention.