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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 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, or military status. Employees, 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. MCW’s policy as well as federal and state laws and regulations prohibit unlawful discrimination and harassment.

Notice of Compliance with Laws and Commitment to Civil Rights
The Medical College of Wisconsin is committed to full compliance with all applicable federal, state, and local laws and regulations in the pursuit of our missions. Consistent with recent federal guidance, we affirm our commitment to individual merit, fairness, and equal treatment in all aspects of academic and institutional decision-making. As part of this commitment, we are actively reviewing our policies and materials to ensure they align with federal nondiscrimination obligations.