• Dry Eye New Patient Appointment Request

  • If you are a new patient, please fill out the form below, once completed, a member of our team will reach out to schedule you for an appointment

    For established patients, please message our care team: https://www.app.elationpassport.com/patient-portal/login
  • Welcome to Periman Eye Institute. We specialize in comprehensive evaluation and treatment of dry eye and ocular surface disease, with a focus on understanding the underlying factors contributing to each patient’s symptoms.

    Our approach is intentionally different from a traditional eye care visit. We dedicate significant time to your evaluation and use specialized diagnostic testing to develop an individualized treatment plan based on your specific findings and goals.

    To allow us to provide this level of specialized, patient-centered care, Periman Eye Institute is a self-pay practice and does not bill insurance. Our team will review the cost of your visit with you in advance, and when appropriate, we can provide documentation that you may submit to your insurance plan for possible out-of-network reimbursement.

    We look forward to learning more about your experience and helping you better understand what may be contributing to your symptoms.

  • Date of Birth*
     - -
  • Sex at birth*
  • Format: (000) 000-0000.
  • Should be Empty: