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Medical Doctor / Health Practitioner Referral

Have a patient you would like to refer us? Complete the form below and we will take care of their eye care needs 🙂


    Diabetic Eye ExaminationReduce VA / Blurred VisionEye Pain / DiscomfortRed Eye / Infection / AllergiesHeadacheDiplopiaEpiphoraPhotopsia / FloatersGlaucoma / Family History of GlaucomaCataracts / Family History of CataractsGeneral Eye ExaminationOther (write in notes)


    Ajax Location: Kodak Lens Harwood Eyecare (314 Harwood Ave. S. in Harwood Plaza)Etobicoke Location: Kodak Lens Cloverdale Eyecare (250 The East Mall in Cloverdale Mall)North York Location: Kodak Lens Centerpoint Eyecare (6464 Yonge St. in Centerpoint Mall)Rexdale Location: Kodak Lens Woodbine Eyecare (500 Rexdale Blvd. in Woodbine Centre Mall)Riverdale Location: Kodak Lens Broadview Eyecare (318 Broadview Ave. South of Gerrard)Scarborough Location: Kodak Lens Parkway Eyecare (85 Ellesmere Rd. in Parkway Mall)Toronto Location: Kodak Lens Toronto Eyecare (364 Yonge St. North of Dundas)

    Disclaimer

    Please inform patient that we will follow up within 12 to 24 hrs. If this is an emergency, please write in notes. Thank you.