top of page

Referring Physicians

How Can We Help?

​

     Thank you for trusting Cardinal Vision to participate in the care of your patient.  Please follow the instructions below to help ensure we meet your request in a timely fashion.

​

NOTE:  Emergent (same day appointment) requests must be called into our office at (803) 999-EYES.

​

​

Please fax the following information to our office at (425) 448-6516.  

​

​     1)  >>Cardinal Vision Referral Form (use link to print form)

​

     2)  A copy of the most recent exam note including  all current

           medications

​

     3)  Release of medical records authorization signed by the patient

​

     4)  Copy of insurance cards (front and back)

​

We will notify your office to confirm the appointment request.

​

NOTE

(Incomplete forms will prompt a phone call from our office for the missing information and may result in a delay of care.)

​

​

** Some medical insurance companies require referrals be initiated by the patient's primary care physician (PCP).  If this is the case, the PCP listed on the patient's insurance card must initiate the referral.**

​

 

​

​

​

​

​

​

​

​

Appointment Request

IF THIS IS AN EMERGENCY CALL 911

​

Thanks for submitting!

You can expect a response within 24-48 hours

bottom of page