Thank you so much for allowing us to co-manage your patient for their myopia control needs!

If you need to download more copies of the form, please click: Co-Management Form

Please complete the form below and we’ll reach out to your patient to schedule their visit.

Myopia Control Co-Management Form

  • Rx Info

  • You can either type in the patient's prescription or take a picture and upload it below.
  • Max. file size: 256 MB.
  • This field is for validation purposes and should be left unchanged.