Forms for Referring Professionals Thank you for kind referrals.Please fax the referral note and medical records to our office fax# 203-738-0523. We will reach out to the patient or have the patient call us for an appointment. Thank you so much for your kind referrals.Referral Form for OptometristsReferral Form for Other Professionals Intakes Forms for Patients will be email to patients after an appointment is scheduled.