(414) 774-3484

Electronic Referral Forms

Please fill out the details in the electronic forms below to submit a new appointment request for Retina and Vitreous Consultants of Wisconsin.

For all referrals, our office will contact the patient soon and your office shortly for supporting documentation.

 For urgent referrals to be seen in less than 24 hours, please submit a referral request and immediately call our office at 414-774-3484 to expedite transfer of records and care in a timely manner. 

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