Consultation Request Form

Thank you for selecting Sabates Eye Centers to assist in the care of your patient. As we have the common goal of exceptional patient care we look forward to working with you as your resource for specialty eye care.

Beyond Clinical Care

If you have any questions, need additional assistance or would be interested in a lunch and learn with one of our specialists or similar opportunity, please contact our Director of Communications.

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Please fill out the form below if you are referring a patient to our practice. We will contact the referring doctor by 5:00pm the next business day.

* (denotes required field)

First Name: *

Last Name: *

E-Mail Address:

Date of Birth *

Home Phone *

Primary Insurance *

Referring Doctor Information:

Doctors Name *

Doctors Phone *

Doctors Email

Appointment Location

Office Location

Any Location Independence Office Leavenworth Office Northland Office Overland Park Office Prairie Village Medical Plaza St Joseph Office St Lukes Medical Plaza Warrensburg Office

Doctor's Name

Any Doctor Felix N. Sabates Nelson R. Sabates David B. Lyon Abraham Poulose Timothy A. Walline Rohit Krishna Michael A. Cassell Komal B. Desai Billi S. Wallce Kevin Pikey Dawn Bircher John Cottle Mahendra K. Rupani Ryan D. Vincent Nancy Kunjukunju Jill R. McNaughton

Preferred Appointment Date

Appointment date must be at least 1 week from today.
We will do our best to match the date/time to accommodate your request

Preferred Appointment Time

01 02 03 04 05 06 07 08 09 10 11 12 : 00 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 AM PM

Reason for Consultation

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For emergency or time sensitive appointments, please call us direct at 913-261-2020 or toll free at 1-800-742-0020.