Forms for Referring Professionals

Please fax the referral form below to our office fax# 203-738-0523.

Referral Form for Optometrists

Referral Form for Other Professionals

Forms for New Patients

Please contact us,  detailed intake forms will email to you.

What to expect for the first appointment at Academy of Vision and Learning?

• A thorough history and questionnaire will be obtained and reviewed before each new patient’s appointment (We will email to you when you make an appointment). We understand that every part of development, including in-utero history, affects how our eyes, brain and body work together.
• Please plan on 2 hours for the initial appointment in our office.
• One parent is required in the exam room and please no siblings.