Clinician Referral Form

Please use this confidential form to refer your patient to an eSight advisor or provide feedback from an in-office demonstration. Upon referring a patient, our eSight team will guide them through their personalized process. Alternatively, your patient can call us directly at 1-855-837-2894.

eSight business professional contact information

Phone: 1-855-465-4615 |Fax: 1-613-482-4703 |E-mail: partner@esighteyewear.com