Medical Release

Request Medical Records:

Please download and fill out the form below, which authorizes your current eye doctor to send copies of your medical records to our office for review. This is essential for your best diagnosis.

Ideally, you will also ask your doctor to include a brief letter summarizing your medical history. This will facilitate our understanding your case with greater clarity, in case the records are challenging to interpret due to handwriting or other issues. Clicking on a link below will automatically download the document to your computer.

Medical Release Form