Join

Membership Enrollment Process

Step 1.  Review EyeAssure Provider Manual. 

Step 2.   Complete and submit the following forms:

• Membership Enrollment Form
• Participating Provider Agreement

Step 3.   Upon receipt by EyeAssure of Membership Enrollment Form and Participating Provider Agreement, you will be contacted by EyeAssure staff to obtain information needed to establish monthly bank draft for payment of membership fees.

               Membership in EyeAssure is effective upon initial payment of membership fees.