Referrals

Referrals

DATE OF REFERRAL:
REFERRING DOCTOR:
NAME OF PRACTICE:
OFFICE PHONE:
OFFICE FAX:
PATIENT NAME:
PATIENT DOB:
PATIENT PHONE:
IS BEING REFERRED TO ATLANTA EYE GROUP FOR EVALUATION AND/OR MANAGEMENT OF:
SUMMARY OF EYE FINDINGS:
SPECIAL TESTS REQUESTED:

  • PLEASE VISIT OUR WEBSITE AT atlantaeyegroup.com TO COMPLETE YOUR NEW PATIENT PAPERWORK AND HAVE IT COMPLETED PRIOR TO YOUR VISIT.

  • IT IS THE PATIENT’S RESPONSIBILITY TO VERIFY INSURANCE PRIOR TO THE DAY OF THE APPOINTMENT.

  • PLEASE BRING YOUR INSURANCE INFORMATION WITH YOU TO THE APPOINTMENT.

  • PLEASE BRING A PAIR OF YOUR GLASSES WITH YOU TO THE EXAM.

  • PLEASE ARRIVE AT LEAST 10 MINUTES BEFORE YOUR SCHEDULED EXAM TIME
    ​​​​​​​

rats3898 none 9:00 AM - 7:00 PM 9:00 AM - 7:00 PM 9:00 AM - 7:00 PM 9:00 AM - 7:00 PM 9:00 AM - 7:00 PM 9:00 AM - 7:00 PM 12:00 PM - 5:00 PM Optometrist # # # 2860 Cumberland Mall SE, Suite 1440
Atlanta, GA 30339 https://www.google.com/maps/place/Atlanta+Eye+Group/@33.880667,-84.469788,15z/data=!4m5!3m4!1s0x0:0xe83d5328c49ea1ca!8m2!3d33.8806673!4d-84.469788?hl=en-US https://www.lenscrafters.com/ScheduleExamView?catalogId=11651&clearExams=1&langId=-1&storeNumber=0638&storeId=10851&cid=Yext_PagesSchedule_Now_LCOD0638 https://search.google.com/local/writereview?placeid=ChIJtVONdBAR9YgRyqGexChTPeg 3393 Peachtree Road NE #B128
Atlanta, GA 30326 https://www.google.com/maps/place/Atlanta+Eye+Group/@33.847235,-84.3647957,17z/data=!3m2!4b1!5s0x88f505f87f2c986d:0x29518e244e5c8f10!4m6!3m5!1s0x88f505571c53615d:0x53f67f8561eb8cfc!8m2!3d33.847235!4d-84.3622154!16s%2Fg%2F11dzdchnp1?hl=en https://www.lenscrafters.com/ScheduleExamView?catalogId=11651&clearExams=1&langId=-1&storeNumber=0252&storeId=10851&cid=Yext_PagesSchedule_Now_LCOD0252 https://search.google.com/local/writereview?placeid=ChIJXWFTHFcF9YgR_IzrYYV_9lM 400 Ernest Barrett Parkway, Suite 617
Kennesaw, GA 30144 https://www.google.com/maps/place/Atlanta+Eye+Group/@34.018025,-84.563789,15z/data=!4m5!3m4!1s0x0:0x4ee1b066f76a97ba!8m2!3d34.0180253!4d-84.5637886?hl=en-US https://www.lenscrafters.com/ScheduleExamView?catalogId=11651&clearExams=1&langId=-1&storeNumber=0256&storeId=10851&cid=Yext_PagesSchedule_Now_LCOD0256 https://search.google.com/local/writereview?placeid=ChIJT9qzgZAV9YgRupdq92aw4U4 4400 Ashford Dunwoody Rd. Suite 1280
Atlanta, GA 30346 https://www.google.com/maps/place/Atlanta+Eye+Group/@33.9230607,-84.3407601,15z/data=!4m5!3m4!1s0x0:0xd15fc7720d7f6740!8m2!3d33.9230607!4d-84.3407601 https://www.lenscrafters.com/ScheduleExamView?catalogId=11651&clearExams=1&langId=-1&storeNumber=0156&storeId=10851&cid=Yext_PagesSchedule_Now_LCOD0156 https://search.google.com/local/writereview?placeid=ChIJiSZb4EQJ9YgRQGd_DXLHX9E 4800 Briarcliff Rd NE, Suite 1173
Atlanta, GA 30345 https://g.page/r/CbPu0fSsZMBIEAI/review https://www.lenscrafters.com/ScheduleExamView?catalogId=11651&clearExams=1&langId=-1&storeNumber=0226&storeId=10851&cid=Yext_PagesSchedule_Now_LCOD0226 https://g.page/r/CbPu0fSsZMBIEBE/review/