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Denver 303-861-2020
Commerce City Office 303-287-3937
Aurora Office 303-307-0200

Home » Patient Referral Form

Patient Referral Form

Please fill out the referral form below. If you prefer to download, print and fax the form, please click here.

  • Patient Information

  • MM slash DD slash YYYY
  • Referring Provider

  • Reason for Referral

  • MM slash DD slash YYYY

Exciting news! Clear Vision Associates - Aurora/GVR is rebranding and moving to a new location. Starting June 12th, we'll be known as Aurora Eye Practice & Optical. Visit us at our new address: 14261 E Cedar Ave Unit C, Aurora, CO 80012.

Medicaid and Denver Health Medicaid accepted which provides free glasses for children and qualifying adults. Personalized one-on-one exams, no tele-optometry. Continued care with our doctors, Dr. Esteban Sandoval, Dr. Chris Hey, and Dr. Paul Grigonis.