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Due to Medicare regulations, we now require a written request from the patient's primary care physician in order to schedule a consultation. In addition to providing this request, you will need to document the reason for the consultation so we may put it in the patient's medical record.

Click here to download a consultation request form. You can make photocopies for future reference. After filling out the form, please fax it to us prior to your patient's scheduled appointment, or you can have your patient bring it on the date of his/her visit.

While we understand that this is another layer of paperwork for physicians, we must all comply with Medicare regulations. We are attempting to make this process less cumbersome for you, but we cannot evaluate your patient without the required paperwork. If your patient arrives without the necessary form, we will need to contact you directly in order to obtain it. This will lead to unnecessary delays for you, your patient and us.

Thank you for your support and confidence in sending your patients to us for treatment. Thank you also for your continued cooperation. We continue to dedicate ourselves to delivering the best care possible.       

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Karl L Schwiesow MD | Tyson K Schwiesow MD | Kurt A Schwiesow MD

Tower Clock Eye Center
1087 West Mason Street
Green Bay, WI 54303
Tel: 920.499.3102

www.towerclockeyecenter.com


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