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Dr. ​Beth Munzel, OD, FCOVD
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Eye Test

Referral Form

Please click on the PDF link below to view the referral form.  You can print it, fill it out, and fax to 513-232-0400 or email to visiontherapystudio@gmail.com. You may also submit online below.

Please encourage patients to reach out if they would like, they do not need to wait to hear from us. We are happy to answer any questions or schedule anyone interested. 

Submit Referral Online

For Referring Doctors or Professionals only. 

If you are an interested patient please call, text or email our office.

Select an option
I am referring the above patient to your office for the following reasons: (Select all that apply)

Thank you for ther referral!

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