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
Low Vision Referral Form 2022
Download Referral FormOnline Referral Form
Fill out my online form.