Refer a patient to IVISION LASER

Referring new patients couldn't be easier

Simply fill out the new patient referral form below and our team will take care of the rest. We welcome referrals for cataract, laser eye surgery and refractive lens surgery, along with other conditions of the eye.

How to refer

You can send a referral in whichever way suits your practice:

• Online: complete the referral form on this page.
• Fax: 08 7082 2016.
• Email: info@ivisionlaser.com.au.
• Phone: call our team on 08 7082 2066 if you would like to discuss a patient before referring.

What to include

To help us prepare for your patient's visit, it is useful to provide:

• The reason for referral and the area of concern.
• Relevant ocular and contact lens history.
• Your patient's contact details so we can arrange their appointment.
• Your details as the referring practitioner, including your provider number.

How the process works

Once we receive your referral, our team contacts your patient to arrange a suitable appointment. Dr Aanchal Gupta assesses their eyes and discusses the options that may suit them. We keep you informed about your patient's care throughout.

Patient Referral Form

* indicates a required field.

Referral details

Reason for referral * Please select Cataract Laser Eye Surgery Refractive Lens Surgery Other

Ocular & contact lens history

Patient details

First name

Last name

Date of birth

Address

City

State

Postcode

Contact number

Email address *

Referrer details

Referrer's name

Practice name and address

Referrer's phone number

Provider number *

Today's date

Send referral By sending this form you confirm your patient is aware of the referral. We handle all information in line with our privacy policy.