Patient Referrals & Consultation Requests

Partnering to provide exceptional eye care across Central Ohio

Referral Process

We value our relationships with our health care community partners. To support optimal patient care and provider communication, we offer a simple, streamlined referral process.

Just select one of the options below to refer a patient electronically or by paper form. Once we receive your referral, our Patient Services staff will contact the patient to schedule an appointment at a time that works for them. Once scheduled, we will notify your office of the appointment date and time. After the examination, a copy of the findings and any relevant testing will be sent to the referring doctor.

Referral Options

Download the electronic Consultation Request form from one of the Clinic options below:

Main Campus Clinic Consultation Request Form

To refer a patient electronically, complete this fillable document and then send an encrypted email to opt-medrec@osu.edu.
To refer via fax, print and complete this form on paper and fax to 614-247-6626.
Upper Arlington Clinic Consultation Request Form

To refer a patient electronically, complete this fillable document and then send an encrypted email to opt-medrec@osu.edu.
To refer via fax, print and complete this form on paper and fax to 614-247-6626.
Pickerington Clinic Consultation Request Form

To refer a patient electronically, complete this fillable document and then send an encrypted email to opt-medrec@osu.edu.
To refer via fax, print and complete this form on paper and fax to 614-247-1795.

Ohio State Optometry goes to great lengths to send outgoing email securely and store emails securely; however, please be aware that incoming email (i.e. sent to us), unless encrypted via appropriate means, is not secure. Please reach out to us if you would like more details on sending email securely.

Important Security Notice:

Ohio State Optometry takes extensive measures to send and store email securely. However, please note that incoming email (unless encrypted using appropriate methods) is not secure. If you would like guidance on how to send email securely, please contact us for more information.

Referring Office Contact Information Update

Has your practice moved? Changed locations? Added a new site?

Help us keep your referral information up to date to ensure continuity of excellent patient care. Please email us at opt-medrec@osu.edu with your name, practice name, and updated address, phone, and fax (as applicable).