Referring Physicians — Aggarwal Eye Care

Taylor Office

10501 Telegraph Rd, Suite 102
Taylor, MI 48180

(313) 228-5341

Mon–Fri, 9 AM–5 PM

Livonia Office

28900 Joy Rd
Livonia, MI 48150

(734) 425-2514

Mon–Fri, 9 AM–5 PM

Printable Referral Slip

Download and print our standard referral form to send with your patient.

Download PDF

Request a Referral Call-Back

Send us your contact details and our referral coordinator will call your office back within one business day to take the patient’s information by phone. We send you a consultation report after the visit.

Referring Physician

Physician name *

Practice / Clinic

Physician phone *

Fax

For patient privacy, please don’t enter patient names, dates of birth or clinical details on this form. Our referral coordinator will call your office back to take them by phone — or send your patient with the printable referral slip above.

Referral Request

Preferred office for the patient

Best time to call your office

Urgency

Urgent — same day / ASAP 3–6 days 1–2 weeks Routine — next available

Urgent referrals: call us directly — (313) 228-5341 Taylor · (734) 425-2514 Livonia