Please use the form below to refer a patient to The Lighthouse. Learn more about our Services and Programs by visiting our Clinical Services Home Page.

Please use the referral form to connect your patients with our services. You may submit the form electronically via the online form below, or you may fax the Referral to Lighthouse International Low Vision/ Vision Rehabilitation Form to (212) 821-9710. Upon receipt, we will contact the patient to arrange for the services that meet the individual's needs.

PLEASE NOTE: The Lighthouse Low Vision Center has locations in New York City and Westchester.
Vision Rehabilitation Services are provided throughout the five boroughs of New York City, Westchester and the Hudson Valley.

We look forward to helping your patients who have vision loss, so that they can function as independently -- and safely -- as possible in their daily lives.

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