Referring Physicians

To provide our patients with the most comprehensive eye care, we value working in conjunction with referring ophthalmologists, optometrists and primary care physicians.

The form below (PDF) may be used by referring physicians to facilitate patient referrals to Mid Atlantic Retina. Please print, complete and fax to the preferred location.

Physician Referral Form (PDF)

You may also contact us at 1 (800) 331-6634 to set up an appointment.