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Referring Optometrists: Optometrist Forms

For any billing questions or co-management questions, please call our billing department at 570-628-4444

Connie---ext. 117
Cheryl---ext. 130
Susan---ext. 136
Patty---ext. 120
Kathy---ext. 129
Irene---ext. 118

This form should be filled out when a optometrist refers to one of our doctors here at Progressive Vision Institute.

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This form is for an optometirst to fill out when referring a patient for a LASIK evaluation.

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Thank you for entrusting the care of your patient to Progressive Vision Institute.
Thank you very much for your referral.