Submit Appointment Request Patient details:Email Address *Phone NumberAge *Referral provider details:Phone numberReason For Visit *Reason For Visit?Retina assessmentRetinal tear or detachmentMacular hole or epiretinal membraneRetinal vein occlusionMacular degenerationDiabetic eye diseaseCataractUveitisGlaucomaGenetic retinal disorderOtherAdditional Information *Choose FileNo file chosenDelete uploaded fileUpload your referral letterSend Message Learn more about Dr. Steven Lapere’s Practice Here