Get the free Specialty Contact Lens Referral Form - med emory

This form is used for referring patients to the Emory Eye Center for specialty contact lens services. It requires information from the referring provider and the patient to facilitate the appointment process.

How to fill out specialty contact lens referral

How to fill out specialty contact lens referral

1. Gather patient information including full name, date of birth, and contact details.
2. Obtain detailed medical history related to eye conditions and previous lens usage.
3. Specify the type of specialty contact lenses required (e.g., scleral, toric, orthokeratology).
4. Indicate reasons for referral, including any specific vision issues the patient is facing.
5. Include any relevant diagnostic information or test results related to corneal shape or health.
6. Fill out any insurance information for billing and coverage purposes.
7. Sign and date the referral form before submitting it to the specialty lens provider.

Who needs specialty contact lens referral?

1. Individuals with complex vision issues such as keratoconus or irregular astigmatism.
2. Patients seeking comfort and improved vision when standard contact lenses are unsuitable.
3. People with unique eye shapes or conditions that require specialized lens designs.
4. Patients with previous unsuccessful attempts to fit standard contact lenses.

For pdfFiller’s FAQs

How can I modify specialty contact lens referral without leaving Google Drive?

It is possible to significantly enhance your document management and form preparation by combining pdfFiller with Google Docs. This will allow you to generate papers, amend them, and sign them straight from your Google Drive. Use the add-on to convert your specialty contact lens referral into a dynamic fillable form that can be managed and signed using any internet-connected device.

How do I make changes in specialty contact lens referral?

With pdfFiller, it's easy to make changes. Open your specialty contact lens referral in the editor, which is very easy to use and understand. When you go there, you'll be able to black out and change text, write and erase, add images, draw lines, arrows, and more. You can also add sticky notes and text boxes.

How do I edit specialty contact lens referral on an iOS device?

You certainly can. You can quickly edit, distribute, and sign specialty contact lens referral on your iOS device with the pdfFiller mobile app. Purchase it from the Apple Store and install it in seconds. The program is free, but in order to purchase a subscription or activate a free trial, you must first establish an account.

What is specialty contact lens referral?

A specialty contact lens referral is a formal request for evaluation and fitting of specialty contact lenses that necessitate expertise beyond standard fittings, often used for patients with specific vision needs or unique eye conditions.

Who is required to file specialty contact lens referral?

Typically, optometrists or ophthalmologists who determine that a patient requires specialty contact lenses are required to file a specialty contact lens referral.

How to fill out specialty contact lens referral?

To fill out a specialty contact lens referral, the referring eye care professional must provide patient details, the specific type of specialty lens requested, and any relevant medical history or findings related to the patient's vision.

What is the purpose of specialty contact lens referral?

The purpose of a specialty contact lens referral is to ensure that patients who require specialized lenses receive appropriate expertise and care, improving the chances of successful fitting and effective vision correction.

What information must be reported on specialty contact lens referral?

The referral must include the patient's name, contact information, specific lens type requested, medical history, and any relevant testing results that support the need for specialty lenses.