For Referring Doctors

We know that choosing and referring an eye care provider is a choice that comes after careful thought and assessment. When you refer a patient to Katzen, we strive to provide quick responses and clear communication to make this process that much easier. To refer a patient, please fill out the referral form below.

If you would like to discuss this referral; have questions about CE or co-managing; would like referral forms or marketing materials; or would like to receive additional information for your patients on premium IOLs or LASIK, please contact Ayda Said at (410) 530-6802 or saydasaid@katzeneye.com.

1 Patient Information

2 Referring Doctor

First & Last Name*
Date of Birth*
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DD
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Email*
Phone*
Insurance Care Provider
Reason for Consultation*
Please specify reason for consultation:

For Referring DoctorsThank you for giving us the opportunity to be a part of your patient’s journey to vision restoration or aesthetic satisfaction.

For Referring DoctorsThank you for giving us the opportunity to be a part of your patient’s
journey to vision restoration or aesthetic satisfaction.