Patient Referral Form

Referrals don’t need to be complicated. If you’d like to refer a patient to our Long Island ophthalmology practice, download, print, and complete the form on this page. With 17 locations throughout Long Island and a long history of embracing new and innovative therapies, OCLI is staffed by a team of physicians ready to be your patient’s eye care partner. From the management of chronic conditions like diabetic retinopathy to complex glaucoma cases, we’re well-equipped to diagnose and treat patients in a comfortable, care-focused setting.

Download the Physician Referral Form

When complete, fax the form to 1-844-211-6254.

To learn more about the referral process, please call our practice liaison at (516) 804-5247.