Referring Doctors – Forms
Note: Referring Doctors Request an Appointment – coming soon.
Referring Doctors Information Note: You will need Adobe Acrobat Reader to view these forms. If you do not have Adobe Acrobat Reader, you may download it by clicking here.
- Referral Form
- Outside Testing Request Form
- Surgical History & Physical Form *
- Cataract Co-Management Policy
- Cataract Post-Operative Form
- Laser Vision Correction Pre-Operative Referral Form for Dr. Varley
- Post-Operative Co-Management Form for Dr. Varley
*CEI is now performing Surgical History and Physical Exams. Please contact us at 513-984-5133.
If you are participating in Stage 2 Meaningful Use, below are CEI’s direct email addresses for our doctors. You may need these to enter into your direct website so you can send CCD (Continuity of Care Documents) to CEI electronically.