Northwest Animal Eye Specialists

13020 NE 85th Street
Kirkland, WA 98033

(425)827-3966

www.northwestanimaleye.com

REFERRING VETERINARIANS
 
When referring a patient, please download and complete our referral form. Please fax or email (email preferred) back to us with any related records. 
 *Please note: Your client will still need to reach out to us to begin the scheduling process. 

Email: eyeonpets@northwestanimaleye.com

Kirkland fax: 425-827-1422

Renton fax: 425-264-0375


 
New Patient Referral Form

Our doctors are available for phone consultations with veterinarians. Please submit the following form and one of our doctors will get back to you as soon as possible. If your case is an emergency and you need an immediate response, it would be best to contact our office directly.

Referring Veterinarians Form

Name (required)
First Name (required)
Last Name (required)
Organization Name (required)

E-Mail Address (required) :
Daytime Phone (required)
Phone TypePhone Number (required)
Evening Phone (required)
Phone TypePhone Number (required)
What is the patient's name? (required)

Do you wish to refer the patient for treatment at NWAES or are you only looking for a consultation with an ophthalmologist? For consultations we will get back to you as soon as possible. It may take up to 2 business days to receive a reply. (required)

Is this a mutual patient or a new case for NWAES? (required)

Please provide more details about the patient and their eye issue. (required)


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