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Our Doctors
Dana Tannenbaum, M.D.
Mario A. Meallet, M.D.
Stavros N. Moysidis, M.D.
Dr. Cynthia Boxrud, M.D.
Sitara Hirji, M.D.
Our Staff
Eyecare Services
Cataract Care
What is a Cataract?
Testing for Cataracts
Treatment for Cataracts
Laser Cataract Surgery – VICTUS
ORA VerifEye+ & Cataract Surgery
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ReSTOR ® Multifocal IOL
Crystalens ® Accommodating IOL
Crystalens® vision workbooks
TRULIGN ® Toric
TECNIS ® Multifocal IOL
Toric® IOL
Glaucoma Care
What is Glaucoma?
Diagnosing Glaucoma
Treating Glaucoma
Lasers for Glaucoma
Glaucoma Surgery
iStent Surgery
ExPRESS Mini-Shunt Surgery
Trabeculectomy Surgery
Tube-Shunt Surgery
Primary Eye Care
LASIK Laser Vision Correction
LASIK Laser Vision Correction
INTRALASE ®
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Cornea Care
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Home
A Center for VisionCare – Referral Form
Date:
Referral To
Dr. Tannenbaum
Glaucoma/Cataract
Dr. Meallet
General Opth/Cornea/Cataract/Glaucoma
Dr. Hirji
General Opth/Glaucoma/Cataract
Dr. Boxrud
Oculoplastics/Eyelid/Botox
Dr. Moysidis
Retina
Schedule with First Available
Patient Information
First Name: *
Last Name: *
Address:
Phone Number: *
Best Time to Call:
AM
PM
Both
Email:
Self Referred:
Yes
No
Insurance Information
Insurance Name:
Member ID:
Group #:
Dx(s):
Reason for Referral:
Referring Doctor Information
Referring Doctor: *
Phone Number:
Fax:
Email:
Submit Referral
Note:
After clicking submit, you will receive a confirmation. Our team will contact the patient within 1-2 business days to schedule their appointment.
