Skip to main content
Menu
autumn_lake-slide
Home ยป Vision Therapy Assessment Referral Form

Vision Therapy Assessment Referral Form

  • Section 1: Referring Healthcare Provider

  • Date Format: DD slash MM slash YYYY
  • Section 2: Patient Information

  • Date Format: DD slash MM slash YYYY
  • Please enter a number from 10 to 10.
  • Refraction & BCVA:
  • Refraction & BCVA:
x

Urgent Care Only

At this time, our St. Catharines Office will be closed and our Niagara-on-the-Lake Office will be taking only urgent care patients.

Our office hours will be limited due to new restrictions so please call and leave a detailed message and we will return your call within 2 hours during the day or by the next morning if the message is left after hours. Take care and be well!!

Niagara-on-the-Lake Office Phone: (905) 468-8002