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Become an Affiliate

Signing up is easy, just fill out the following form below and submit it.  After submitting the form, a Woolfson Eye Institute Practice Manager will contact you shortly to provide appropriate patient information booklets and a Woolfson Eye Institute affiliate guidebook.  To find the Practice Manager closest to your area please click here.

General Information:

Practice Name:

Address:

City:

State:

Zip:

Phone::

Fax::

Email:

Website:

Federal Tax ID#:

Doctor's Names:
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(enter doctor names exactly how you would like them to appear, and also in the
order you would like
them to appear)

Additional Information:

Coordinator Information:

Coordinator's Name:

Coordinator's Phone:

Coordinator's Email:

Security Information:

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Practice Managers:

Lisa Nardone – Atlanta
800 Mt. Vernon Hwy. Suite 130
Atlanta, GA  30328
404-237-1770 v
404-237-6002 f
404-434-7885 cell

lnardone@woolfsoneye.com

Pat Welch – Gwinnett
1980 Riverside Pkwy. Suite 120
Lawrenceville, GA  30043
770-407-2009 v
770-407-2013 f
404-992-3933 cell

pwelch@woolfsoneye.com

Anne Riley – Stockbridge
7454 Hannover Pkwy. Suite 120
Stockbridge, GA  30281
770-506-6955 v
770-506-3966 f
404-456-2241 cell

ariley@woolfsoneye.com

Amy Carlson-Jacko – Asheville
One Town Square, Suite 110
Asheville, NC  28803
828-651-8662 v
828-654-8160 f
828-335-3779 cell

acarlson-jacko@woolfsoneye.com

Trish Eubanks – Chattanooga
7405 Shallowford Rd. Suite 320
Chattanooga, TN  37421
423-894-5300 v
423-894-8331 f
423-580-8147 cell

teubanks@woolfsoneye.com

Amy Mynatt – Knoxville
10240 Kingston Pike
Knoxville, TN 37922
865-691-6348 v
865-691-7478 f
865-604-7244 cell

amynatt@woolfsoneye.com

John Burrows – Greenville/Clemson/Columbia
3531 Pelham Rd. Suite 100
Greenville, SC  29615
864-281-3800 v
864-281-3883 f
864-907-3671 cell
jburrows@woolfsoneye.com

   


 

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