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Medical College of Wisconsin Eye Institute - Referring Physicians Information

For Referring Physicians

Patient and physicians alike look to the Eye Institute for help with the most complicated eye diseases. Use the links to the right to download our PDF referral forms.

Patient Referral Form

Download Form
Imaging Test Request

Download Form

Non-Discrimination, Anti-Harassment, and Legal Compliance Statement
The Medical College of Wisconsin (MCW) is committed to fostering a diverse community of outstanding faculty, staff, and students, as well as ensuring equal educational opportunity, employment, and access to services, programs, and activities, without regard to an individual's race, color, national origin, religion, age, disability, sex, gender identity/expression, sexual orientation, marital status, pregnancy, predisposing genetic characteristic, military status, or other legally protected classification. MCW maintains full compliance with all applicable federal, state, and local laws and regulations in pursuit of our missions. Consistent with federal guidance, we affirm our commitment to individual merit, fairness, and equal treatment in all aspects of academic and institutional decision-making.

MCW's policies, federal and state laws, and regulations prohibit unlawful discrimination and harassment. Employees, learners, students, applicants, or other members of the MCW community (including but not limited to vendors, visitors, and guests) may not be subjected to harassment that is prohibited by law or treated adversely or retaliated against based upon a protected characteristic.