Refer a Patient/Consultation Request

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Doctors reviewing a chartWe welcome the opportunity to partner with you in caring for your patients. To refer a patient to Ohio State Optometry Services, please use our electronic Satellite Clinic Consultation Request form. You can complete this electronically or print and complete on paper.

Once completed, you can send the document using encrypted email to or by fax to 614-247-6626.

Referral Process 

We value our relationships with our health care community partners. In order to provide optimal patient care and communication with providers we have an easy referral process. 

Simply, complete one of the menu options below to refer a patient electronically or on paper. Once we receive your referral our patient services staff will contact the patient to schedule their appointment at a time convenient for them. When we have the patient scheduled we will notify you of their appointment date and time. After the examination, we will send a copy of the exam findings and any relevant testing back to the referring doctor.

  • Download the electronic Satellite Clinic Consultation Request form
  • Complete the fillable document electronically
  • Send an encrypted email to
    • 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.

Referring Office Contact Information Update

Has your practice moved locations? Have you changed where you practice? Has your practice added a new location?

Help us keep up to date with our referral information to continue excellent patient care together by emailing us at Please provide us with your name, practice name, and updated address, phone, and fax (as applicable).

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Regular Hours of Operation:

Monday:  9 a.m. - 5 p.m.
Tuesday:  8 a.m. - 5 p.m.
Wednesday:  8 a.m. - 5 p.m.
Thursday:  8 a.m. - 5 p.m.
Friday:  8 a.m. - 5 p.m.

2023 Holiday schedule notes:

Monday, January 16: Closed
Monday, May 29: Closed
Monday, June 19: Closed
Tuesday, July 4: Closed
Monday, September 4: Closed
Friday, November 10: Closed
Thursday, November 23: Closed
Friday, November 24: Closed
Monday, December 25: Closed
Tuesday, December 26: Closed
Wednesday, December 27: Closed
Thursday, December 28: Closed
Friday, December 29: Closed
Monday, January 1, 2024: Closed