Ophthalmology Referral Form
This service is for veterinarians only – clients seeking medical information should contact their regular veterinarian for assistance.
If you would like to make a referral to the Small Animal or Equine Ophthalmology service and you do NOT need to speak to an Ophthalmology clinician, you can use this form to submit the client and patient information.
For Farm Animals or Exotics, please submit a referral directly through those respective services.
Please attach to this online form, send via email (firstname.lastname@example.org), or fax (919.513.6711) supporting information, such as eye photos, records, diagnostic test results, or radiographs/ultrasound reports.