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  • Daniel Weinberg, O.D., F.C.O.V.D.
    Zachery Weinberg, O.D.
    4414 Shelbyville Road, Suite 204
    Louisville, Kentucky 40207
    FAX 502.894.9912

     

  • FUNCTIONAL/DEVELOPMENTAL VISION EVALUATION FAX REFERRAL FORM

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  • Results of Examination

    Eyeglass Rx

  • I hereby grant permission for Dr. Weinberg and any other practitioner involved in my care to exchange information concerning my case, history, results of examination, diagnoses, treatment, etc. I hereby give permission to have this information faxed to Dr. Weinberg so that his office can contact me (or an appointed representative) to schedule an evaluation.

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  • A copy of all tests results and a report will be sent to the referring doctor.
    Please call Dr. Weinberg’s office at (502) 894-4434 if a report has not been received in a timely fashion.
    Patients will return to referring doctor’s office for all primary care and eyeglass prescriptions.

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