Partner application

Apply to become an EyeRise partner.

For optometrists and eye care practices. No-work patient setup pathway, no inventory, and a patient-friendly QR flow your team can recommend in under 30 seconds.

60-second commitment · Review within 2–3 business days · Optional Stripe Connect auto-deposit

Contact

Full name *

Email *

Phone number *

Practice

Clinic / practice name *

Practice website

City *

State / region *

Country *

Role *

Practice type *

Number of doctors *

Volume

Estimated active patients

Approx. patients seen per month

Do patients commonly complain about screen-related symptoms? *

YesNoNot sure

Interest

Main interest *

How soon would you like to start? *

Message

I agree that EyeRise may contact me about the partner program, and I understand that EyeRise is a digital wellness product, not a diagnostic device or substitute for professional eye care.

EyeRise is wellness software and does not provide medical advice, diagnosis, or treatment. For medical concerns, patients should consult a qualified eye-care professional.