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Thank you for considering Lumina Vision Therapy for your patient’s or student’s care!
If you are a healthcare professional, therapist, reading specialist, educator, or other professional interested in referring someone for a Functional Vision Evaluation, please complete the referral form.
Please include your reason for referral and any relevant concerns or observations to help us understand the individual’s needs.
You can also fax patient records to our office at (978) - 277 - 7626.
What happens next?
Our team will contact the patient or their parent/guardian to explain the evaluation process, answer questions, and assist with scheduling.
Your office should receive a follow up letter from our office regarding the referral.
Patient Referral Form
Teacher Questionnaire Form
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