Referring Doctors | Pepose Vision Institute St Louis

Hard Copy of Referral Forms

Referral FormDownload

Downloadable hard copy for secure referrals. If our digital form isn’t accessible, please send this version via encrypted email or fax to protect patient privacy.

Co-Management Consent FormDownload

This consent form is completed in-office when surgery is scheduled. It outlines the shared care agreement between our team and yours for seamless co-management.

Co-Management Premium BreakdownDownload

An overview of our co-management premium structure. We’ve partnered with CoFi to offer transparent pricing, financing, and flexible payment options for your patients.

Co-Management ReportDownload

This form will be used to document and finalize the transfer of care once your patient is released back to you following surgery.

Refractive Post-Operative CareDownload

A comprehensive guide to post-op care for LASIK, PRK, and other refractive procedures. Given to every patient when surgery is booked to help guide expectations and follow-up timelines.

Cataract Post-Operative CareDownload

A detailed outline of post-op care for cataract and clear lens exchange (CLE) patients, including helpful tips for managing special cases and timelines for follow-up care.

Keratoconus Post-Operative CareDownload

Care guidelines for patients undergoing keratoconus treatments, including crosslinking and CTAK. Provided at the time of booking to ensure patients and providers are aligned on expectations.

FAQsDownload

Quick answers to common questions about referrals, co-management, timelines, and billing — designed to make the referral and co-management process simple and predictable for your team.

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