Refer a patient
South Atlantic Retina accepts referrals from optometrists, ophthalmologists, primary care physicians, and endocrinologists across Jacksonville and Northeast Florida. This page is written for your front desk: how to send a referral, what to send with it, and what comes back to you.
3627 University Blvd S, Suite 605, Jacksonville, FL 32216
Monday–Friday, 8:00 am – 5:00 pm
How to send a referral
- Download the form that matches your practice, below.
- Fax it to (904) 605-4872 with any imaging or notes you have.
- For an emergent case, call (904) 666-5050 first and fax afterward.
No portal account is needed, and there is no need to call ahead for a routine referral. If it is easier for your staff to fax your own referral form or a chart note instead of ours, that is fine — we need enough to reach the patient and to understand why they are coming.
What to send with it
- Patient name, date of birth, and a phone number the patient answers
- Insurance name and member ID
- The reason for referral, in a sentence
- Whatever imaging you have — OCT, fundus photographs, visual fields
- Your fax number for the report
Records help but are not required. We would rather see the patient without imaging than not see them.
How urgency is handled
If you are not sure which category a patient belongs in, call. It is a short conversation and we would rather have it than have you guess.
What comes back to you
A consultation report — findings, imaging, the plan, and the follow-up interval — is faxed to your office within 48 hours of the visit. If a patient does not schedule or does not show, your office is told. The patient returns to you for their routine eye care.
Referral forms
Eye Care Provider Referral
For optometrists and ophthalmologists referring for medical or surgical retina care. Page 2 is a patient handout — see below.
Download PDFPrimary Care & Endocrinology
For diabetic retinal imaging, retina wellness screening, and consultation.
Download PDFPatient Handout
“What to Expect at Your Visit” on its own, if you would rather keep a stack at the front desk.
Download PDFPlease give page 2 to your patient
The second page of the Eye Care Provider Referral is written for the patient, not for us. It covers where we are, where to park, that both eyes will be dilated for four to six hours, that a new patient visit runs one to two hours, when to arrange a driver, and what to do if symptoms worsen before the appointment.
Handing it over at the moment you make the referral saves your staff the follow-up phone calls, and it means the patient arrives knowing what the visit involves. Print it on its own from the third download above if that is easier.
What we see
Medical and surgical retina for adults and children: diabetic retinopathy, macular degeneration, retinal tears and detachments, macular holes and epiretinal membranes, vein and artery occlusions, vitreous hemorrhage, central serous retinopathy, uveitis and ocular inflammation, inherited retinal disease, sickle cell retinopathy, choroidal nevi and lesions, Plaquenil and other drug toxicity screening, and post-operative or post-injection complications. Conditions we treat and surgeries we perform describe these in more detail.
Pediatric retina is seen by referral from a pediatric ophthalmologist, ophthalmologist or optometrist. Children are not scheduled directly from a parent’s phone call — they should be examined by their own eye doctor first and referred if the retina needs attention. More on pediatric retina.
Questions about a specific patient, or about whether something needs to be seen this week — call (904) 666-5050.