Refer a Client

How to Make a Referral

If you are an Eye Care Physician - How to refer a patient to the Low Vision Clinic at the Center for the Visually Impaired:

  1. Fill out the Patient Referral Form.
  2. Fax the completed Patient Referral Form to Client Services at 404.875.4568.
  3. Please include a copy of the patient's latest eye report, if possible.
  4. Client Services staff will contact your patient to complete the application process over the telephone and schedule an appointment at CVI.

If you are a Community Service Provider - How to refer a client to the Low Vision Clinic at the Center for the Visually Impaired:

  1. Ask the patient to sign the Authorization to Release Information Form.
  2. Fill out the Client Referral Form.
  3. Fax the completed Client Referral Form and the signed Authorization to Release Information Form to Client Services at 404.875.4568.
  4. Client Services staff will contact your client to complete the application process over the telephone and schedule an appointment at CVI.

You may also make a referral via telephone. Contact an intake counselor in the Client Services Department at 404.875.9011 for assistance.