Submit Referral

Referrers please submit your referral via our web form below or via fax

For referrers :


Thank you kindly for your referral.  Once submitted to us we will keep on file and await the patient to contact us for an appointment.

We encourage your feedback on our service and welcome you to call us at any time on (02) 8883 5886.

    If you already have a referral form please upload it here:

    Upload Referral : (File types accepted: .pdf .doc .docx .jpg .jpeg .png - Max File Size 10MB)

      Alternatively please fill in the Referral Form below to submit your referral to us

      Patient Details

      Referring Practitioner Details

      Select Ophthalmic Surgeon (optional)



      Monday – Friday 8:30am – 4:30pm
      Saturday CLOSED
      Sunday CLOSED