Doctor Directory Form

Until the day that research leads to prevention or a cure, time is of the essence in diagnosing and successfully treating patients with Coats’ Disease. The Jack McGovern Coats’ Disease Foundation Doctor Directory is a resource for patients and their families to swiftly identify preeminent ophthalmologists in their area so they can access quality medical care quickly. We invite you to join us as we work to find a cure for Coats’ Disease.

If you are a physician specializing in Coats’ Disease, please consider submitting your information.

Or, consider nominating a doctor to join our Directory by completing the form yourself. You may also download a PDF version to take with you to your next appointment.



*Indicates a required field.

By submitting this form, you are providing the Foundation and their representatives permission to list the information you provide on the Doctor Directory Website which will be accessible to the public. Furthermore, you agree that all the information you have provided is accurate and up-to-date.



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