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Physician Access Intake Form (Providers + Staff Only)

Referring a patient has never been easier. Simply fill out our refer a patient form and one of our referral coordinators will immediately follow up with you. Having trouble? No problem. Just call our Physician Access Line at 617-636-7255.

This form should only be filled out by physicians or their staff.

This site is not designed to and does not provide medical advice, professional diagnosis, opinion, treatment or services to you or to any other individual. See more information.

In the case of a medical emergency, please call 911 for immediate assistance.

Ophthalmology (New England Eye Center)

260 Tremont Street
Biewend Building, 9-11th Floor
Boston, MA 02116

  • Ph: 617-636-4600
  • Fx: 617-636-4866

Laser Vision Center

Biewend Building, 11th Floor
260 Tremont Street
Boston, MA 02116

  • Ph: 888-51-LASIK
  • Fx: 617-636-9267

Pediatric Ophthalmology

755 Washington Street
Floating Hospital for Children, 6th Floor
Boston, MA 02111

  • Ph: 617-636-6769
  • Fx: 617-636-3305

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