Referring Physician Information

Referring Providers – If you would like to refer a patient for a retinal consultation please completely fill out the fax form below and fax it to our office (fax number listed below).  If you feel this is an emergency that needs to be seen today, please fax over the completed form and then call our office and alert the receptionist to notify the on call physician.  Thank you for trusting us with your patients!

FAX REFERRAL FORM

2478 Patterson Road, Suite 7
Grand Junction, CO
81505-1266
Phone: 970-255-7065
Fax: 970-255-7076