Request an Appointment
Serving both Fort Myers and Naples residents, if you would like to request an appointment at one of our locations, please complete the form to the left and we will contact you soon.
Note: We are not able to accept CONFIRMATIONS or CANCELLATIONS via the form. If you need to confirm or cancel your appointment with a Retina Health Center Serving both Fort Myers and Naples residents specialist, please call our office direct.
Tips for Surgery
With offices in Fort Myers and Naples, Florida, the Retina Health Center team is focused on the highest quality care available for our patients. We offer the most progressive treatment options available and are committed to keeping each patient safe and comfortable during their procedures.
Patient Information Form
Record Release Form
New Patient Packet
Patient Medical History
Medications & Drug Allergies
Patient Acknowledgement Authorization
Financial Agreement & Assignment of Benefits
Notice of Privacy Practices
Amsler Grid & Eye Chart