Skip to main content
Work With Us

FOR REFERRING DOCTORS

Home » Information for Referring Doctors

Collaboration is key at New England Retina Associates as we continue to partner with numerous referring physicians in and around the Fairfield and New Haven Counties. Our goal is to provide the same exceptional care you offer to your patients.

To schedule a consultation for your patient, simply contact any of our three offices in Fairfield or the one in New Haven. We do our best to offer prompt appointments and accommodate emergencies.

Download Vitreo-Retinal Consult Order Form ›

eye iris

Vitreo-Retinal Consult Order Form

This field is hidden when viewing the form
Diagnostic Testing
Primary Eye to be Studied:
Patient’s Name:
MM slash DD slash YYYY
Referring Physician:
MM slash DD slash YYYY
Location:

Instructions to Patient:


Your eyes will be dilated so we advise you to have a driver. You will be in our office a minimum of two hours. If your insurance requires a referral, please be sure to obtain one prior to your visit.

x
Important announcement regarding the Change Healthcare data breach: https://www.retinamd.com/change-healthcare-announcement/