Thank you for your referral partnership! Create an account for our shared dashboard, or use the online form below to easily refer a patient to Colorado Retina Associates. You can also download and fill out the PDF referral form, accessible at the bottom of the page.
Referrals will be processed during normal business hours, Monday-Friday 8:00am-4:00pm MT. For emergent referrals and patients that need to be seen within 72 hours, call 303-261-1600 and follow the prompts for providers or triage.
Referring Provider Survey
To better meet the needs of our referring providers, please complete our annual satisfaction survey below.
Ways to Submit a Referral:
1. Shared Referral Dashboard
A HIPAA-secure referral dashboard via Phreesia. Your team can easily submit new and track past referrals, SELF-SCHEDULE patients before they leave your office, attach patient documents/imaging, receive live status updates, and utilize the chat to quickly communicate with a scheduling representative, all without ever faxing or picking up the phone!
2. Online Form
Fill out the retina or sub-speciality online referral form to submit an appointment request instantly.
3. Fax or Email
If you prefer to fax or email referrals, download our Patient Referral Form, fill out all fields, and send it along with the required patient documents: exam notes, imaging: OCT/FA, demographics, and copy of patients’ insurance cards.
Fax: (303) 261-1601
Medical Records Release Form
Your patient or their legal representative must fill out this form authorizing the release of the patients' medical information. When complete, have the patient fax the completed form to (303) 261-1601 or email firstname.lastname@example.org. Allow 5-7 business days for processing.
Stoke Evaluation Referral Form
Early detection of Retinal Artery Occlusion (BRAO or CRAO) or Transient Monocular Vision Loss (TMVL) requires immediate evaluation and transfer to a stroke center to avoid subsequent clinical strokes and decrease chance of long-term disability. Our editable stroke eval referral form template is meant to assist you and your patients in the referral process when you spot symptoms suggestive of stroke. In addition, the form lists all recommended Denver Metro Comprehensive Level 1 Stroke Centers (CSC) who offer the full spectrum of neuroendovascular therapy.