Retinal Vascular Disease Urgent Referral Forms

Timely referral of patients with newly identified retinal vascular disease is of utmost importance to their visual outcome.

The attached forms can be faxed directly to the patient’s local eye department. Fax numbers and addresses are on base of the forms. The urgency of the patient’s appointment will be determined by the Unit and they will contact the patient within two weeks. It is therefore vital that the patient’s current telephone number is accurately recorded on the referral form as is their full and legal first name and surname.

The AMD Rapid Access Referral Form can be found here

The Diabetic Macular Oedema Referral Form can be found here

The Retinal Vein Occlusion Referral Form can be found here