Patient Referral Process
Download our New Patient Appointment form and fax the completed document(s) to our scheduling department at 1-866-843-7990. We will then contact your patient promptly, or your office if requested, to finalize the patient’s appointment.
Our scheduling department is available Monday-Friday, 8:00am to 5:00pm.
In addition to the patient’s demographics, our staff will request the following information:
- Desired appointment time, date, and location
- If you prefer the patient to be seen by a specific RNW physician
- The patient’s complete current insurance information, including a copy of all cards
- Chart notes
Patient Referral for Diagnostic Testing
Complete and fax the following Diagnostic Orders and Scheduling Worksheet form along with your orders, diagnosis, insurance information and applicable chart notes to 1-866-843-7990.
Physicians may refer their patients to Retina Northwest for the following diagnostic procedures, with interpretation:
- Color Fundus Photography
- Fluorescein Angiography **
- Indocyanine Green (ICG) Angiography **
- Spectral-domain OCT
- Retinal Ultrasound
**Angiography interpretation is optional and is provided upon request.