Referral Materials

banner

NON-URGENT REFERRAL FORM


 
Print

APPOINTMENT CARD

After scheduling an appointment in our office, complete this appointment card for your patient to inform them of their appointment date and time at our office, instructions for their appointment, and directions to our office.
 

 

 

 

 

 

 

 

URGENT REFERRAL FORM


Print

PHONE CALL SCREENING INFORMATION FOR URGENT REFERRALS 

When referring a patient with an urgent diagnosis such as a retinal detachment or retinal tear, please review our Phone Call Screening Information for Urgent Referrals form and have all the necessary information available when calling to make the referral.  If the patient needs to be seen within 24 hours of the referral phone call, the patient must be present in your office when the referral call is made.