Patient Information


Whether you’re a new patient whom we haven’t had the pleasure of meeting yet or a returning patient who has been with us for years, welcome to the patient information section of our website. Please use the resources on this page to access new patient forms, insurance information, our refer a friend program, and to review your doctor.


cullom and farah new patient forms

New Patient Forms


We are happy to provide all necessary forms required for your appointment in advance to make your visit as convenient as possible.

Please click the button below to print and fill out the New Patient/Annual Appointment Paperwork to expedite your visit.


Download PDF
cullom and farah referrals

Refer a Friend


Referrals to our practice are the highest form of compliment we can receive. If you have a friend or family member who could benefit from the high quality eye care we offer, please complete the form below, and we will email them with information about our center.

insurance information

Insurance Information


We participate with most insurance plans. To find out if your specific insurance plan is accepted for our eye care services, please contact us at (757) 345-3001. If your insurance plan requires a referral, please have your primary care provider fax the referral to (757) 345-3102.

Please be advised that your co-pay and or refraction fee is due at the time of service. We accept most methods of payment including debit and check cards.

It is important that you understand that your Vision Plan (VSP, EyeMed, or Comp Benefits) covers ROUTINE eye care only (nearsightedness, farsightedness, and normal astigmatism).

Our doctors are committed to giving you the highest quality eye care. Our physicians will examine you for many medical conditions such as glaucoma, dry eyes, cataracts, retinal holes or tears, diabetic and hypertensive eye disease, among many others. If your eye exam involves a medical condition related to your eyes that requires specific counseling, documentation, follow-up care, regular monitoring, or referral to a surgeon, then your visit is NOT COVERED by your Vision Plan, but may be covered by your medical insurance. Unfortunately, the doctor cannot tell if medical eye conditions exist before you are thoroughly examined.

Review Your Doctor


Sharing your story not only helps our team to improve, but also helps other prospective patients decide whether Cullom & Farah Eye & Laser Center is the right provider for them. Please select your doctor to submit a review of your experience.

Douglas Cullom, M.D. Anthony Farah, M.D. Mary Ellen Cullom, M.D. Leana Long, M.D. Matthew Reed, M.D. Gary Fredericksen, O.D., F.A.A.O.

Have any questions?


Get in Touch


To get the answers to your questions, or to request a consultation, call us at 757-771-1543.


cullom and farah new patients