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GREENBELT7500 Greenway Center DrSuite 300Greenbelt, MD 20770
CUMBERLAND625 Kent AvenueSuite 201Cumberland, MD 21502
ROCKVILLE14995 Shady Grove RdSuite 110Rockville, MD 20850
Phone: (301) 277-4844 | Fax: (301) 927-3221 washingtoneyeinstitute.com
Emergency / TraumaCornea / Anterior SegmentCataractsRetina / MaculaGlaucoma / Optic NerveDiabetic Eye Exam
Pterygium RemovalBotox InjectionsLaser Peripheral IridotomyKeratoconus / Cross-linkingSpecialty ContactsOther: _______________
Washington Eye Institute Locations:
Date of Referral:
Diagnosis / Reason for Referral:
Name and Phone #:
Medical History / Clinical Information: Referring Doctor Name & Email:
Referring Doctor Phone & Fax:
Michael Summerfield, MDComprehensive Ophthalmology
Cataract, Glaucoma &Refractive Surgery
Rajini Seevaratnam, OD MScComprehensive Medical Optometry
Specialty Contact Lens
Reena Garg, MDCataract & Glaucoma surgery
Cataract Surgery
Phillip Liggins, ODComprehensive Medical Optometry
Routine Contact Lens
Lamees Ashker, MDCorneal Specialist
Cataract, Refractive Surgery
Diana Chu, ODComprehensive Medical Optometry,
Specialty Contact Lens