Retina-Vitreous Associates Medical Group
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Forms and Documents
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Forms and Documents

Below is a link to a downloadable initial referral form for referring doctors. Referring doctors can fill out the form with the patient's name and condition. An area on the form for questions ruling out a diagnosis or requesting clearance for other ocular procedures is provided as well.

Referring doctors can also download history forms for patients to complete before arriving for the first consultation, though the forms can also be completed upon arrival at the office. If your patient is coming for his or her first visit and plans to complete the history forms at the office, we recommend that he or she arrives at least fifteen minutes early.

- Map and Referral Form for Referring Doctors PDF

- New Patient Packet PDF

- Medical Records Release Form PDF

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The information on this website is for general information purposes only. Nothing on this site should be taken as medical advice for any individual case or situation. This information is not intended to create, and receipt or viewing does not constitute, a patient-physician relationship.