Refer a patient

All referrals are followed up immediately. Use whichever channel suits your practice — or complete the online form below and we’ll take it from there.

✎

Online form

Complete the referral form below — the fastest option.

Healthlink

Send via your practice management system to ESA4EYES

Oculo

Find us on Oculo as Eye Surgery Associates, Auckland.

Email / PDF

Email a letter or our PDF referral form to admin@eyesurgeryassociates.co.nz

Online referral form

For GP and optometrist use only. Urgent cases are triaged the same day — for emergencies, please phone 09 275 1750.

Referrer

Your nameRequired

Practice name (optional)

You are a

GPOptometrist

Email for correspondenceValid email required

Patient

First nameRequired

Last nameRequired

AddressRequired

Patient emailValid email required

Patient phone (optional)

Date of birth (optional)

NHI number (if known)

Clinical details

Suspected condition (optional)

Urgency

RoutineSemi-urgentUrgent

Vision — left (optional)

Vision — right (optional)

Clinical notes (optional)

You are sending us health information about your patient. We use it to triage the referral and arrange their care, and it reaches our practice inbox by email. Please make sure your patient knows you are referring them. Our privacy policy explains where it is stored, how we handle it, and how a patient can get a copy.

This form needs the Cloudflare verification below to send, and it isn’t loading. Please allow scripts from challenges.cloudflare.com, or contact us on 09 275 1750 or admin@eyesurgeryassociates.co.nz.

Referrals are followed up immediately during clinic hours.