Healthcare Services

Refer Patient

Contact
Medical professionals shaking hands.

For Doctors and Professionals

Please submit the online referral form below or download the form and return to Lighthouse Guild by:

Fax: 212-769-7825
Mail: Lighthouse Guild, Attn: Jocelyn Tapia, 250 West 64th Street, New York, NY 10023

Download PDF, 1.2MB

Low Vision Referral Form 2021

Download Referral Form

Online Referral Form

Fill out my online form.